ZPG-12299-02239
4 vaccinations
16 coded responses
45 check-ins
15 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 605 / IL
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-15
Registered in v-safe
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2021-02-15
Dose 1 — Moderna
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2021-02-15
Survey response — day 0, dose 1MedDRA: Unevaluable event — Feeling: Fair · FeverFree text: Normal temp 97.4 low grade for meMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-02-17
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
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2021-03-01
Survey response — day 14, dose 1MedDRA: Headache, Injection site rash, Pyrexia — Feeling: PoorFree text: Headache day before repeat of rash around injection on 9th day. First rash reaction time day two with fever and rash on third day. Rash faded after 2 days. Should I get 2nd injection in other arm?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
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2021-03-15
Dose 2 — Moderna
- 2021-03-15
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2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Joint painsAdult check-in
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2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash, Injection site swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Muscle or body achesFree text: Rash spreading with swelling at site and lymph nodes under arm. 2nd injection reactions more than first.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Pain, Rash — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessFree text: Rash appears to be fading but still some painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · Joint pains, Muscle or body achesFree text: Rt arm swollen lymph nodes in arm pitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Injection site rash, Oedema peripheral — Feeling: Fair · Site: Swelling · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Arm pit of injected arm swollen and achy .swelling in this area now with out any changes of going away. Rash at injection has faded just swelling in arm pit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-21
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Lymphadenopathy, Pain in extremity — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Arm pit gland still swollen with pain running down arm to hand since third day this is sixth day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — day 7, dose 2MedDRA: Discomfort, Lymphadenopathy, Pain in extremity — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Arm pit swelling had ultrasound unable to say why swollen as lymph nodes are ok. Swelling causes pressure on nerve endings resulting pain in arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Survey response — day 14, dose 2MedDRA: Axillary pain, Oedema peripheral, Office visit, Ultrasound scan abnormal — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Continue to have swelling in right arm pit in same arm that I received injection on 3-15-21 noticed swelling on 3-19 and still swollen as if 3-29 · Healthcare visit (other): Dr for ultrasound of arm pit lymph nodes, nodes ok but soft tissue swelling with painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-05
Survey response — day 21, dose 2MedDRA: Arthralgia, Gait disturbance, Inflammation, Injection site discolouration, Injection site pain, Injection site rash, Myalgia, Oedema peripheral, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Still have arm pit swelling with pain radiating from shoulder, triceps, elbow to hand. Noting inflammation in feet and difficulty walking. Shot given high on shoulder experienced pain immediately and now with discoloration of still visible from rash.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
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2021-04-19
Survey response — day 35, dose 2MedDRA: Axillary pain, Oedema peripheral, Swelling — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Continue to have swelling in arm pit pain which radiates down my arm.Five weeks after injection. Swelling appeared approx on day 4. When to expect this reaction to go away?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
- 2021-06-14
- 2021-09-13
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2021-10-25
Dose 3 — Moderna
- 2021-10-25
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2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Injection site bruising — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body achesFree text: Bruising at injectionMedDRA releases: 2024-11 · check-in free text available
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
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2022-03-11
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-04-05
Dose 4 — Moderna
- 2022-04-19
- 2022-04-26
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2022-05-03
Survey response — day 28, dose 4MedDRA: Dizziness postural, Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Vertigo experiencing some dizziness upon getting up.MedDRA releases: 2024-11 · check-in free text available
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2022-05-10
Survey response — day 35, dose 4MedDRA: Body temperature increased, Cough, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sinus runny nose,constant coughing low grade temp.3 rd day same.MedDRA releases: 2024-11 · check-in free text available
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2022-05-17
Survey response — day 42, dose 4MedDRA: Cough, Office visit, Rales — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Coughing more with crackling chest sounds. Saw Pulmonologist for further treatment today. & new rxMedDRA releases: 2024-11 · check-in free text available
- 2022-07-05
- 2022-10-04
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2023-04-05
Survey response — 12 months, dose 4MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitMedDRA releases: 2024-11
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2023-04-05
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
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2023-04-06
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Moderna | |
| 2 | 2021-03-15 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-05 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-29 | Successful 2022-03-11 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2023-04-05 | Successful 2023-04-06 |
Completed over the phone |
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): Normal temp 97.4 low grade for me
Release 4 — day 14, dose 1
Symptoms: Headache day before repeat of rash around injection on 9th day. First rash reaction time day two with fever and rash on third day. Rash faded after 2 days. Should I get 2nd injection in other arm?
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Rash spreading with swelling at site and lymph nodes under arm. 2nd injection reactions more than first.
Systemic reaction (other): Rash appears to be fading but still some pain
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Rt arm swollen lymph nodes in arm pit
Systemic reaction (other): Arm pit of injected arm swollen and achy .swelling in this area now with out any changes of going away. Rash at injection has faded just swelling in arm pit.
Systemic reaction (other): Arm pit gland still swollen with pain running down arm to hand since third day this is sixth day.
Release 6 — day 7, dose 2
Systemic reaction (other): Arm pit swelling had ultrasound unable to say why swollen as lymph nodes are ok. Swelling causes pressure on nerve endings resulting pain in arm.
Release 6 — day 14, dose 2
Symptoms: Continue to have swelling in right arm pit in same arm that I received injection on 3-15-21 noticed swelling on 3-19 and still swollen as if 3-29
Healthcare visit (other): Dr for ultrasound of arm pit lymph nodes, nodes ok but soft tissue swelling with pain
Release 6 — day 21, dose 2
Symptoms: Still have arm pit swelling with pain radiating from shoulder, triceps, elbow to hand. Noting inflammation in feet and difficulty walking. Shot given high on shoulder experienced pain immediately and now with discoloration of still visible from rash. cut off by CDC
Release 7 — day 35, dose 2
Symptoms: Continue to have swelling in arm pit pain which radiates down my arm.Five weeks after injection. Swelling appeared approx on day 4. When to expect this reaction to go away?
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Bruising at injection
Release 11 — day 28, dose 4
Symptoms: Vertigo experiencing some dizziness upon getting up.
Release 11 — day 35, dose 4
Symptoms: Sinus runny nose,constant coughing low grade temp.3 rd day same.
Release 11 — day 42, dose 4
Symptoms: Coughing more with crackling chest sounds. Saw Pulmonologist for further treatment today. & new rx
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 | Axillary pain | ✓ | ✓ | ✓ |
| HCVO | Oedema peripheral | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Ultrasound scan abnormal | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Axillary pain | ✓ | ✓ | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dizziness postural | · | · | ✓ |
| SD | Gait disturbance | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Injection site discolouration | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Oedema peripheral | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rales | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Swelling | ✓ | ✓ | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | · | · | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release