27U-49044-32430

2 vaccinations 8 coded responses 14 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 971 / OR
Registered: 2021-04-08

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

2021-03-10
Dose 1 — Moderna
2021-04-07
Dose 2 — Moderna
2021-04-08
Registered in v-safe
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Memory impairment, Nightmare, Palpitations — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Anxiety, racing heart, nightmares, sporatic short term memory problems

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Agitation, Amnesia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Agitation, alertness, short term memory issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Agitation, Amnesia, Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Agitation, poor short term memory, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-30
Survey response — day 21, dose 2
MedDRA: Axillary mass, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lump in armpit area of left arm, same arm that I received 2nd dose. Lump is size and consistency of a grape. Noticed lump on the 10th day after 2nd injection. I see my PCP on 05/03/2021. Also random nausea beginning day after I discovered the lump.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-12
Survey response — day 35, dose 2
MedDRA: Headache, Myalgia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Muscle aches and headaches are back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-08
Survey response — 3 months, dose 2
MedDRA: Hypertension, Office visit, Peripheral swelling — Feeling: Fair · Be unable to work or attend school, 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: Symptoms: High blood pressure, swelling in extremeties · Healthcare visit (other): PCP

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-12
Call 1 — Left Voicemail
2021-10-07
Survey response — 6 months, dose 2
MedDRA: Disturbance in attention, Musculoskeletal stiffness, Vision blurred — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Blurry vision, neck stiffness, easily distracted

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Survey response — 12 months, dose 2
MedDRA: Arthropod bite, Blood pressure inadequately controlled, Diabetes mellitus inadequate control, Infected bite, Skin irritation — Feeling: Poor · Be unable to work or attend school, 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, Hospitalization

Free text: Uncontrolled high blood sugar despite adjustments to medications to maintain desired levels. High, uncontrolled blood pressure despite newly prescribed medication to lower. Minor skin irritations i.e. insect bites etc becoming major infections.

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Anxiety, racing heart, nightmares, sporatic short term memory problems

2021-04-11

Systemic reaction (other): Agitation, alertness, short term memory issues

2021-04-12

Systemic reaction (other): Agitation, poor short term memory, brain fog

Release 8 — day 21, dose 2

2021-04-30

Symptoms: Lump in armpit area of left arm, same arm that I received 2nd dose. Lump is size and consistency of a grape. Noticed lump on the 10th day after 2nd injection. I see my PCP on 05/03/2021. Also random nausea beginning day after I discovered the lump. cut off by CDC

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Muscle aches and headaches are back.

Release 9 — 3 months, dose 2

2021-07-08

Symptoms: High blood pressure, swelling in extremeties

Healthcare visit (other): PCP

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: Blurry vision, neck stiffness, easily distracted

Release 11 — 12 months, dose 2

2022-04-09

Symptoms: Uncontrolled high blood sugar despite adjustments to medications to maintain desired levels. High, uncontrolled blood pressure despite newly prescribed medication to lower. Minor skin irritations i.e. insect bites etc becoming major infections.

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	Arthropod bite	·	·	✓
SD	Axillary mass	✓	✓	✓
SD	Blood pressure inadequately controlled	·	·	✓
SD	Diabetes mellitus inadequate control	·	·	✓
SD	Disturbance in attention	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Infected bite	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Skin irritation	·	·	✓
SD	Vision blurred	·	·	✓
SRO	Agitation	✓	✓	✓
SRO	Amnesia	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Nightmare	✓	✓	✓
SRO	Palpitations	✓	✓	✓

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