29H-26099-98031

4 vaccinations 12 coded responses 38 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 973 / OR
Registered: 2021-01-12

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Moderna
2021-01-12
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Injection Site Tenderness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling, Itching · Headache

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness · Chills, Headache, Nausea

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Chills, Headache

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Middle ear effusion — Feeling: Fair · Site: Itching · Headache, Muscle or body aches

Free text: Ear pain and sounds of fluid in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Hypoacusis — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Both ears hurt and sounds are muffled and watery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 7, dose 2
MedDRA: Ear pain, Tinnitus — Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness

Free text: Ear pain and fluid sounds in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Survey response — day 21, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feeling more tired and body is craving more sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache, Pre-existing disease — Feeling: Fair · Be unable to work

Free text: Just been feeling more fatigued and having headaches much more since the second dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Wolff-Parkinson-White syndrome — Feeling: Good · Be unable to do your normal daily activities

Free text: WPW syndrome has had more occurrences since covid and even more so as Ive had the vaccine and been working out.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Cyst — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cyst

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-22
Dose 3 — Moderna
2021-09-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-09-24
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-27
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema, Skin discolouration — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Red circle is starting to yellow and feels like it is a bruise

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Survey response — days 1–6 daily, dose 3
MedDRA: Contusion, Erythema — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Free text: Redness is now minimal but it is now transitioning to a bruise in the exact spot

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Survey response — day 7, dose 3
MedDRA: Contusion, Erythema, Swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Free text: Bruising replace swollen red spot.

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Moderna
2022-09-22
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-09-22	Moderna	No
4	2022-04-15	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-12

Systemic reaction (other): Injection Site Tenderness

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Ear pain and sounds of fluid in ears

2021-02-15

Systemic reaction (other): Both ears hurt and sounds are muffled and watery

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): Ear pain and fluid sounds in ears

Release 4 — day 21, dose 2

2021-03-02

Symptoms: Feeling more tired and body is craving more sleep

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Just been feeling more fatigued and having headaches much more since the second dose

Release 6 — day 42, dose 2

2021-03-25

Symptoms: WPW syndrome has had more occurrences since covid and even more so as Ive had the vaccine and been working out.

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Cyst

Release 9 — days 1–6 daily, dose 3

2021-09-24

Systemic reaction (other): Loss of appetite

2021-09-27

Systemic reaction (other): Red circle is starting to yellow and feels like it is a bruise

2021-09-28

Systemic reaction (other): Redness is now minimal but it is now transitioning to a bruise in the exact spot

Release 9 — day 7, dose 3

2021-09-29

Systemic reaction (other): Bruising replace swollen red spot.

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	Condition aggravated	✓	✓	✓
SD	Cyst	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Wolff-Parkinson-White syndrome	○	✓	○
SRO	Contusion	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Erythema	·	·	✓
SRO	Hypoacusis	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Middle ear effusion	✓	✓	✓
SRO	Skin discolouration	·	·	✓
SRO	Swelling	·	·	✓
SRO	Tinnitus	✓	✓	✓

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