2EW-27806-61118

3 vaccinations 13 coded responses 40 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 000
Registered: 2021-03-12

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Registered dependents

89K-30564-33440 Child or adolescent in my care · Female · 2022-02-11

MCY-66027-70265 Child or adolescent in my care · Male · 2022-02-11

Timeline

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Moderna
2021-03-12
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — day 14, dose 1
MedDRA: Respiratory tract congestion, Sinus pain — Feeling: Fair

Free text: Sinus pain, temporal temperature of 98.9F, congestion

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

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Supraclavicular fossa pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: collarbone on shot side hurts

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: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Nausea · Be unable to do your normal daily activities

Free text: lymph node swelling and tenderness at collarbone on shot side

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: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: swollen lymph node collar bone near shot arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness

Free text: swollen lymph nodes on neck and near collar bone on the same side as the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness · Fatigue or tiredness

Free text: swollen lymph node, swelling reduced compared to yesterday, swelling of lymph node still present near collarbone on same side as shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness

Free text: slightly swollen lymph node at collar bone on same side as shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Diarrhea, Abdominal pain

Free text: slightly swollen lymph node at collar bone on same side as shot

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

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Fatigue, Nasopharyngitis, Pyrexia, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Summer cold: runny nose, congestion, low fever, fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2021-11-12
Dose 3 — Pfizer-BioNTech
2021-11-13
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-21
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-26
Survey response — day 14, dose 3
MedDRA: Pre-existing disease, Sinusitis — Feeling: Good

Free text: Allergy induced sinusitis

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 28, dose 3
MedDRA: Headache — Feeling: Good

Free text: Headaches

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-15
Survey response — 6 months, dose 3
MedDRA: Cough, Rhinorrhoea, Sinus congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sinus congestion, runny nose, cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Survey response — 12 months, dose 3
MedDRA: Anal cancer, Office visit — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Anal cancer · Healthcare visit (other): oncologist

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Report sent to call center — 12 months, dose 3
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)
2022-11-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-09	Moderna
3	2021-11-12	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-03-26

Symptoms: Sinus pain, temporal temperature of 98.9F, congestion

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): collarbone on shot side hurts

2021-04-11

Systemic reaction (other): lymph node swelling and tenderness at collarbone on shot side

2021-04-12

Systemic reaction (other): swollen lymph node collar bone near shot arm

2021-04-13

Systemic reaction (other): swollen lymph nodes on neck and near collar bone on the same side as the shot

2021-04-14

Systemic reaction (other): swollen lymph node, swelling reduced compared to yesterday, swelling of lymph node still present near collarbone on same side as shot

2021-04-15

Systemic reaction (other): slightly swollen lymph node at collar bone on same side as shot

Release 7 — day 7, dose 2

2021-04-16

Systemic reaction (other): slightly swollen lymph node at collar bone on same side as shot

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: Summer cold: runny nose, congestion, low fever, fatigue

Release 10 — day 14, dose 3

2021-11-26

Symptoms: Allergy induced sinusitis

Release 10 — day 28, dose 3

2021-12-10

Symptoms: Headaches

Release 11 — 6 months, dose 3

2022-05-15

Symptoms: Sinus congestion, runny nose, cough

Release 12 — 12 months, dose 3

2022-11-12

Symptoms: Anal cancer

Healthcare visit (other): oncologist

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	Anal cancer	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinus pain	✓	✓	✓
SD	Sinusitis	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Supraclavicular fossa pain	✓	✓	✓

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