2SR-26764-43866

5 vaccinations 12 coded responses 26 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 946 / CA
Registered: 2021-02-19

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-18
Dose 1 — Moderna
2021-02-19
Registered in v-safe
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Sinus headache, Sinusitis — Feeling: Good

Free text: I had a sinus headache. I have sinusitis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Lacrimation increased, Rhinorrhoea, Sinus disorder — Feeling: Fair

Free text: Runny nose. Watery eyes. I initially attributed. Mild to my sinusus which i have year round but it seems to be more prevalent.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Rhinorrhoea — Feeling: Fair · Fatigue or tiredness

Free text: Mild: runny nose, tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-18
Dose 2 — Moderna
2021-03-18
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Fair · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy, chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Very tired after cook8ng breakfast. Exhausted. And I slept well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea — Feeling: Fair · Nausea

Free text: I have nausea on a regular basis so I can't say it is rekated to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Gastrointestinal bacterial infection — Feeling: Good · 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 had a stomach bacterial infection.

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
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)
2021-09-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-02
Dose 3 — Moderna
2022-03-18
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal disorder, Sinus disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Stomschbproblems and sunus issues.

MedDRA releases: 2024-11 · check-in free text available
2022-03-18
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-03-21
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-25
Dose 4 — Moderna
2022-10-07
Dose 5 — Moderna
2022-11-23
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-11-23
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-06
Survey response — 3 months, dose 5
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-07
Survey response — 6 months, dose 5
MedDRA: Sinusitis — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-18	Moderna
2	2021-03-18	Moderna
3	2021-11-02	Moderna	No
4	2022-05-25	Moderna	No
5	2022-10-07	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-19

Systemic reaction (other): I had a sinus headache. I have sinusitis.

2021-02-21

Systemic reaction (other): Runny nose. Watery eyes. I initially attributed. Mild to my sinusus which i have year round but it seems to be more prevalent.

2021-02-23

Systemic reaction (other): Mild: runny nose, tiredness

Release 4 — day 7, dose 1

2021-02-25

Systemic reaction (other): No

Release 5 — day 0, dose 2

2021-03-18

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Dizzy, chest pain

2021-03-21

Systemic reaction (other): Very tired after cook8ng breakfast. Exhausted. And I slept well.

2021-03-24

Systemic reaction (other): I have nausea on a regular basis so I can't say it is rekated to vaccine.

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: I had a stomach bacterial infection.

Release 11 — 12 months, dose 2

2022-03-18

Symptoms: Stomschbproblems and sunus issues.

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	Gastrointestinal bacterial infection	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Sinus headache	✓	✓	✓
SRO	Sinusitis	✓	✓	✓

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