ZNZ-14978-92410

4 vaccinations 11 coded responses 37 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 967 / HI
Registered: 2021-03-17

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-17
Registered in v-safe
2021-03-17
Dose 1 — Moderna
2021-03-17
Survey response — day 0, dose 1
MedDRA: Hyperhidrosis — Feeling: Good · Site: Pain

Free text: Occasionally a little sweat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness

Free text: Swollen lymph node above left collar bone. Visible

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Lymph node above left collar bone still swollen but has gone down slightly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Lymph node still swollen but seems to be smaller

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Lymph node very small now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Survey response — day 42, dose 2
MedDRA: Diarrhoea, Fatigue, Office visit, Pyrexia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Diarrhea fever fatigue · Healthcare visit (other): Saw my pcp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-14
Dose 3 — Moderna
2022-04-16
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-12
Call successful
Not applicable - Accidental Reporting
2022-05-15
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-17
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph nodes under left arm and side of breast and on neck line same side

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — days 1–6 daily, dose 4
MedDRA: Erythema, Lymph node pain, Lymphadenopathy — Feeling: Good · Headache

Free text: Lymph nodes still swollen in clavicle area, left side and red but not as red as yesterday. Lymph nodes under left arm and along side of breast still slightly tender

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good

Free text: Lymph nodes still swollen but definitely went down . Still a little painful under left arm

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Survey response — days 1–6 daily, dose 4
MedDRA: Lymph node pain — Feeling: Good

Free text: Lymph nodes less sore

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-22
Health check-in — day 7, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-05-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-19
Survey response — day 35, dose 4
MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, stuffy nose

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna
3	2021-12-14	Moderna	No
4	2022-05-15	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-26	Successful 2022-05-12	Not applicable - Accidental Reporting

Free text

Release 5 — day 0, dose 1

2021-03-17

Systemic reaction (other): Occasionally a little sweat

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Swollen lymph node above left collar bone. Visible

2021-04-16

Systemic reaction (other): Lymph node above left collar bone still swollen but has gone down slightly

2021-04-17

Systemic reaction (other): Lymph node still swollen but seems to be smaller

2021-04-20

Systemic reaction (other): Lymph node very small now

Release 8 — day 42, dose 2

2021-05-26

Symptoms: Diarrhea fever fatigue

Healthcare visit (other): Saw my pcp

Release 11 — days 1–6 daily, dose 4

2022-05-17

Systemic reaction (other): Swollen lymph nodes under left arm and side of breast and on neck line same side

2022-05-18

Systemic reaction (other): Lymph nodes still swollen in clavicle area, left side and red but not as red as yesterday. Lymph nodes under left arm and along side of breast still slightly tender

2022-05-19

Systemic reaction (other): Lymph nodes still swollen but definitely went down . Still a little painful under left arm

2022-05-20

Systemic reaction (other): Lymph nodes less sore

Release 12 — day 35, dose 4

2022-06-19

Symptoms: Sore throat, stuffy nose

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Office visit	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Erythema	·	·	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release