ZP4-15368-43238

4 vaccinations 6 coded responses 27 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 777 / TX
Registered: 2021-01-18

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-15
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Survey response — day 14, dose 1
MedDRA: Erythema, Pain in extremity, Peripheral swelling — Feeling: Fair

Free text: My arm was doing ok, but a friend went to hug me and put her arm around me and squeed, my arm started hurting and swelling turn red, it's still is red and hurts alittle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-12
Dose 2 — Moderna
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 42, dose 2
MedDRA: Office visit, Pain in extremity, Peripheral swelling — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left hand has been swelling and also the side of my hand hurts my doctor called in a prescription for my hand and I will be getting it x-ray on that hand, it's been like this for two weeks, but I thought it would have gone down · Healthcare visit (other): Just saw my family doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Survey response — 3 months, dose 2
MedDRA: Grip strength decreased, Impaired driving ability, Loss of personal independence in daily activities, Pain in extremity, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: My hands are swollen and it makes it hard to do anything or to hold on to things and I can't drive, they hurt to much

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-24
Dose 3 — Pfizer-BioNTech
2022-01-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-26
Dose 4 — Pfizer-BioNTech
2022-04-27
Survey response — days 1–6 daily, dose 4
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Just the one's I check

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-05-03
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-24
Survey response — day 28, dose 4
MedDRA: Adverse reaction, Headache, Malaise, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: I feel like I'm getting sick, my arm feels better, but I been having headache's and nausea, I don't believe that it's because of the shot, because I was giving new medication so I don't know if it's because the shot or the medicine

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Survey response — day 35, dose 4
MedDRA: Ageusia, Chills, Decreased appetite, Feeling abnormal, Oropharyngeal pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Been feeling bad for two days my throat hurts and I have been having chills but this morning I do feel better I don't really eat much I have no taste,but I do eat some because I'm a diabetic I'm hoping that this well pass

MedDRA releases: 2024-11 · check-in free text available
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-25
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-04-26
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna
3	2021-11-24	Pfizer-BioNTech	No
4	2022-04-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-26	Successful 2022-01-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — day 14, dose 1

2021-01-29

Symptoms: My arm was doing ok, but a friend went to hug me and put her arm around me and squeed, my arm started hurting and swelling turn red, it's still is red and hurts alittle

Release 6 — day 42, dose 2

2021-03-26

Symptoms: My left hand has been swelling and also the side of my hand hurts my doctor called in a prescription for my hand and I will be getting it x-ray on that hand, it's been like this for two weeks, but I thought it would have gone down

Healthcare visit (other): Just saw my family doctor

Release 8 — 3 months, dose 2

2021-05-14

Symptoms: My hands are swollen and it makes it hard to do anything or to hold on to things and I can't drive, they hurt to much

Release 11 — days 1–6 daily, dose 4

2022-04-27

Systemic reaction (other): Just the one's I check

Release 11 — day 28, dose 4

2022-05-24

Symptoms: I feel like I'm getting sick, my arm feels better, but I been having headache's and nausea, I don't believe that it's because of the shot, because I was giving new medication so I don't know if it's because the shot or the medicine

Release 11 — day 35, dose 4

2022-05-31

Symptoms: Been feeling bad for two days my throat hurts and I have been having chills but this morning I do feel better I don't really eat much I have no taste,but I do eat some because I'm a diabetic I'm hoping that this well pass

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	Adverse reaction	·	·	✓
SD	Ageusia	·	·	✓
SD	Chills	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Erythema	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Grip strength decreased	·	·	✓
SD	Headache	·	·	✓
SD	Impaired driving ability	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Adverse reaction	·	·	✓

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