ZY8-87063-68049

4 vaccinations 12 coded responses 46 check-ins 11 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 917 / CA
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — day 14, dose 1
MedDRA: Dyspnoea, Feeling abnormal — Feeling: Poor · Be unable to do your normal daily activities

Free text: I have been having problems with shortness of breath. I have never had a fever ever. At first I felt achy but, the shortness of breath just comes on. That is the only thing I feel I still have from the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Dyspnoea, Joint swelling — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Swelling of the joints of fingers and hands. Painful. Shortness of breath started after vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Hypersensitivity, Pain in extremity, Peripheral swelling, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Lots of swelling in my hands and feet. It is painful. Allergies are worse than before. Joint pain has never gone away.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 1 — Left Voicemail
2021-11-01
Dose 3 — Moderna
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-15
Survey response — day 14, dose 3
MedDRA: Arthralgia, Dizziness, Dyspnoea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Short of breath, dizzy spells and joint pain.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — day 21, dose 3
MedDRA: Dyspnoea, Muscular weakness, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shortness of breath. Muscle weakness and pain.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-08
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-31
Survey response — 3 months, dose 3
MedDRA: Dermatitis contact — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Contact Dermatitis

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-12
Dose 4 — Moderna
2022-04-15
Survey response — days 1–6 daily, dose 4
MedDRA: Pneumonia, Pre-existing disease — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I am anemic and have pneumonia.

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-16
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-17
Survey response — days 1–6 daily, dose 4
MedDRA: Dermatitis, Pneumonia, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Dermatitis, pneumonia one lung allergy to something in my house.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-19
Health check-in — day 7, dose 4
Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-22
Call 1 — Left Voicemail
2022-04-26
Survey response — day 14, dose 4
MedDRA: Dermatitis, Peripheral swelling, Pneumonia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Dermatitis, pneumonia, feet, legs and hands swollen. Feet are the worst. Can't fit into shoes.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Report sent to call center — day 14, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-04-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-03
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-10
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-17
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-24
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-12
Survey response — 3 months, dose 4
MedDRA: Condition aggravated, Dermatitis, Lymphoedema, Neuropathy peripheral, Pre-existing disease, Rheumatoid arthritis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Inflamed Dermatitis, Rheumatoid Arthritis or Fibromyalgia flareup. Neuropathy excessive in feet and hands. Lymphedema.

MedDRA releases: 2024-11 · check-in free text available
2022-07-12
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-13
Call successful
Does not wish to fill out VAERS report
2022-10-11
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-04-12
Survey response — 12 months, dose 4
MedDRA: Adverse reaction, Lymphoedema, Platelet count decreased — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-11-01	Moderna	No
4	2022-04-12	Moderna	No

Call center

6 call center cases

4 successful · 2 unsuccessful

See the call center timeline

Free text

Release 3 — day 7, dose 1

2021-02-04

Systemic reaction (other): Short of breath

Release 4 — day 14, dose 1

2021-02-11

Symptoms: I have been having problems with shortness of breath. I have never had a fever ever. At first I felt achy but, the shortness of breath just comes on. That is the only thing I feel I still have from the vaccine.

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Swelling of the joints of fingers and hands. Painful. Shortness of breath started after vaccination.

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Lots of swelling in my hands and feet. It is painful. Allergies are worse than before. Joint pain has never gone away.

Release 10 — day 14, dose 3

2021-11-15

Symptoms: Short of breath, dizzy spells and joint pain.

Release 10 — day 21, dose 3

2021-11-22

Symptoms: Shortness of breath. Muscle weakness and pain.

Release 11 — 3 months, dose 3

2022-01-31

Symptoms: Contact Dermatitis

Release 11 — days 1–6 daily, dose 4

2022-04-15

Systemic reaction (other): I am anemic and have pneumonia.

2022-04-17

Systemic reaction (other): Dermatitis, pneumonia one lung allergy to something in my house.

Release 11 — day 14, dose 4

2022-04-26

Symptoms: Dermatitis, pneumonia, feet, legs and hands swollen. Feet are the worst. Can't fit into shoes.

Release 12 — 3 months, dose 4

2022-07-12

Symptoms: Inflamed Dermatitis, Rheumatoid Arthritis or Fibromyalgia flareup. Neuropathy excessive in feet and hands. Lymphedema.

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
SD	Adverse reaction	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Dermatitis	·	·	✓
SD	Dermatitis contact	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Hypersensitivity	✓	·	✓
SD	Joint swelling	✓	✓	✓
SD	Lymphoedema	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Myalgia	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Pain in extremity	✓	·	✓
SD	Peripheral swelling	✓	·	✓
SD	Platelet count decreased	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Rheumatoid arthritis	·	·	✓
SRO	Dermatitis	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Pneumonia	·	·	✓
SRO	Pre-existing disease	·	·	✓

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