ZSZ-27921-28702

5 vaccinations 19 coded responses 64 check-ins 19 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 856 / AZ
Registered: 2021-03-29

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

Timeline

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

2021-03-27
Dose 1 — Moderna
2021-03-29
Registered in v-safe
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Injection site feels like a slight bruise at this point.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Myalgia — Feeling: Good

Free text: I noticed that the muscle is noticeably slightly sore if using it to lift something not light

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Survey response — day 14, dose 1
MedDRA: Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: This is likely not related: I developed an over proliferation of bacteria on eyelid(s), worse in the right eye leading to swelling and redness. Was likely exacerbated by pollen allergies and the eye being irritated before vaccine; saw optometrist. · Healthcare visit (other): Optometrist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-24
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling of eyelid — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I continue to have a swollen upper right eyelid which appeared 1 week after the 1st dose, and has not gone away with a topical antibiotic. Evaluation is ongoing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema of eyelid, Eyelid disorder, Eyelids pruritus, Office visit, Swelling of eyelid — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): My right eyelids continue to be easily aggravated to swell, itch, redden, but this may be unrelated. · Healthcare visit (other): Office visit for eyelid, but may be unrelated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Swelling of eyelid — Feeling: Good

Free text: Only previously reportÃ¢tes single eyelid somewhat swollen plus rash around that area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Eyelid irritation, Medical counselling, Self-medication, Swelling of eyelid — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): As before some continued swelling and irritation in one eyelid and surrounding area. If I use the prescribed antibiotic and cortisone cream, this seems to be controllable. · Healthcare visit (other): Optometrist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Good

Free text: As before, one eyelid and surrounding area continues to be affected, but seems to be getting gradually better. I have also had a bit of extra popping in the ears since the 2nd dose, but it is not worrisome.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — day 7, dose 2
MedDRA: Blepharospasm, Eyelid irritation, Swelling of eyelid — Feeling: Good

Free text: About the same as yesterday: some residual eyelid swelling/itch/irritation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Hyperhidrosis, Skin odour abnormal — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sweating, extra underarm odor

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sweating

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-18
Survey response — day 14, dose 3
MedDRA: Pruritus — Feeling: Good

Free text: Slight itchiness in specific spots: 1) skin near outer edge of right eye - this happened after initial vaccination, but was more severe at the time - this time, there is no swelling, and the spot is smaller 2) opposite side of arm from shot location

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-09
Survey response — day 35, dose 3
MedDRA: Hypersensitivity, Office visit, Pre-existing disease, Rhinorrhoea, SARS-CoV-2 test, Saliva altered — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have been more easily sensitive to things that I normally have allergy or sensitivity to. This is mostly pollen allergies and food sensitivities: a more perpetually runny nose. Also, some extra thick saliva after a recent vigorous workout. · Healthcare visit (other): COVID test at an Urgent Care

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-10
Call 1 — Left Voicemail
2021-12-13
Call successful
Participant prefers to complete VAERS report online
2021-12-16
Survey response — day 42, dose 3
MedDRA: Condition aggravated, Pre-existing disease, Rash, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: 1) Floaters in left eye. 2) Rash on right rear-portion of shoulder. Note: I have had floaters in both eyes last winter that went away after a few months, but now it is 1 eye, and includes the main part of the visual field instead of periphery only. · Healthcare visit (other): Have not yet scheduled, but intend to.

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-20
Call 1 — Left Voicemail
2022-02-05
Survey response — 3 months, dose 3
MedDRA: Chills, Cough, Fatigue, Respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activities

Free text: Chills, fatigue, cough, congestion

MedDRA releases: 2024-11 · check-in free text available
2022-05-08
Survey response — 6 months, dose 3
MedDRA: Hypersensitivity, Pre-existing disease, Unevaluable event — Feeling: Good

Free text: Exacerbation of allergy: some already affected areas of face and scalp skin became more affected.

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Dose 4 — Pfizer-BioNTech
2022-05-25
Survey response — day 0, dose 4
MedDRA: Arthralgia, Joint noise — Feeling: Good · Fever

Free text: Joint aching and popping

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Adult check-in
2022-05-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2022-06-01
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-08
Survey response — day 14, dose 4
MedDRA: Skin disorder — Feeling: Good

Free text: Unknown skin condition on a certain patch of skin under one eye had become somewhat worse. It started after the first COVID vaccine, gradually improves over months' time, then gets a bit worse again right after each booster or 2nd shot of series.

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-06
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-10
Dose 5 — Moderna
2022-11-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-13
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Chills, Headache, Muscle or body aches

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-15
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-18
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-11-24
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-08
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-15
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-22
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-10
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-11
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2021-11-04	Moderna	No
4	2022-05-25	Pfizer-BioNTech	No
5	2022-11-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-10	Successful	Participant prefers to complete VAERS report online
2021-04-27	Successful	Participant prefers to complete VAERS report online
2021-04-29	Successful	Participant prefers to complete VAERS report online
2021-12-09	Successful 2021-12-13	Participant prefers to complete VAERS report online
2021-12-16	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-31

Systemic reaction (other): Injection site feels like a slight bruise at this point.

2021-04-02

Systemic reaction (other): I noticed that the muscle is noticeably slightly sore if using it to lift something not light

Release 7 — day 14, dose 1

2021-04-10

Symptoms: This is likely not related: I developed an over proliferation of bacteria on eyelid(s), worse in the right eye leading to swelling and redness. Was likely exacerbated by pollen allergies and the eye being irritated before vaccine; saw optometrist. cut off by CDC

Healthcare visit (other): Optometrist

Release 7 — day 0, dose 2

2021-04-24

Systemic reaction (other): Dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): I continue to have a swollen upper right eyelid which appeared 1 week after the 1st dose, and has not gone away with a topical antibiotic. Evaluation is ongoing.

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): My right eyelids continue to be easily aggravated to swell, itch, redden, but this may be unrelated.

Healthcare visit (other): Office visit for eyelid, but may be unrelated

2021-04-28

Systemic reaction (other): Only previously reportÃ¢tes single eyelid somewhat swollen plus rash around that area

2021-04-29

Systemic reaction (other): As before some continued swelling and irritation in one eyelid and surrounding area. If I use the prescribed antibiotic and cortisone cream, this seems to be controllable.

Healthcare visit (other): Optometrist

2021-04-30

Systemic reaction (other): As before, one eyelid and surrounding area continues to be affected, but seems to be getting gradually better. I have also had a bit of extra popping in the ears since the 2nd dose, but it is not worrisome.

Release 8 — day 7, dose 2

2021-05-01

Systemic reaction (other): About the same as yesterday: some residual eyelid swelling/itch/irritation

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Sweating, extra underarm odor

2021-11-06

Systemic reaction (other): Sweating

Release 10 — day 14, dose 3

2021-11-18

Symptoms: Slight itchiness in specific spots: 1) skin near outer edge of right eye - this happened after initial vaccination, but was more severe at the time - this time, there is no swelling, and the spot is smaller 2) opposite side of arm from shot location cut off by CDC

Release 10 — day 35, dose 3

2021-12-09

Symptoms: I have been more easily sensitive to things that I normally have allergy or sensitivity to. This is mostly pollen allergies and food sensitivities: a more perpetually runny nose. Also, some extra thick saliva after a recent vigorous workout.

Healthcare visit (other): COVID test at an Urgent Care

Release 10 — day 42, dose 3

2021-12-16

Symptoms: 1) Floaters in left eye. 2) Rash on right rear-portion of shoulder. Note: I have had floaters in both eyes last winter that went away after a few months, but now it is 1 eye, and includes the main part of the visual field instead of periphery only. cut off by CDC

Healthcare visit (other): Have not yet scheduled, but intend to.

Release 11 — 3 months, dose 3

2022-02-05

Symptoms: Chills, fatigue, cough, congestion

Release 11 — 6 months, dose 3

2022-05-08

Symptoms: Exacerbation of allergy: some already affected areas of face and scalp skin became more affected.

Release 11 — day 0, dose 4

2022-05-25

Systemic reaction (other): Joint aching and popping

Release 11 — day 14, dose 4

2022-06-08

Symptoms: Unknown skin condition on a certain patch of skin under one eye had become somewhat worse. It started after the first COVID vaccine, gradually improves over months' time, then gets a bit worse again right after each booster or 2nd shot of series.

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	Eyelid disorder	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	SARS-CoV-2 test	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Chills	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Saliva altered	·	·	✓
SD	Skin disorder	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Blepharospasm	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Erythema of eyelid	✓	✓	✓
SRO	Eyelid irritation	✓	✓	✓
SRO	Eyelids pruritus	✓	✓	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Joint noise	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Skin odour abnormal	·	·	✓
SRO	Swelling of eyelid	✓	✓	✓

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