37C-32563-19663

2 vaccinations 8 coded responses 19 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 800 / CO
Registered: 2021-03-23

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

2021-03-21
Dose 1 — Moderna
2021-03-23
Registered in v-safe
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Heart rate decreased — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded...low non resting pulse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lack of stamina lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate decreased — Feeling: Good · Fatigue or tiredness

Free text: Still some really low pulse rates (high 30s) at the end of the day, but pulseox still good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-04
Survey response — day 14, dose 1
MedDRA: Injection site rash, Skin warm — Feeling: Fair

Free text: Rash on injection site creeping toward bicep. Hot skin but lower than normal core temp. 96.2, no fever.

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

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Survey response — day 7, dose 2
MedDRA: Rash, Rash erythematous, Rash pruritic, Rash vesicular — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Tiny red hard bumps, started at ankle, working up leg. Like tiny blisters, some clumped together some not. Not super itchy but unlike any other rash I've had

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 14, dose 2
MedDRA: Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities

Free text: Itchy rash on back and, oddly enough, both ankles. Had to cancel some activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-24
Survey response — day 35, dose 2
MedDRA: Dental discomfort, Ear discomfort, Office visit, Pain in jaw, Swelling face — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swelling on right side of jaw, affecting both back molar and right ear. Thought it might be tooth problem. Dentist says no and they have had people reporting similar after covid shots. · Healthcare visit (other): Dentist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-31
Survey response — day 42, dose 2
MedDRA: Ear disorder, Jaw disorder, Lymphadenitis, Office visit, Rash — Feeling: Fair

Free text: Rash continues and seems not to be improving. Problems with jaw/ear dentist office believes are lymphnode inflammation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-19
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-28
Call 1 — Left Voicemail
2022-04-28
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-21	Moderna
2	2021-04-19	Moderna

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Lightheaded...low non resting pulse

2021-03-24

Systemic reaction (other): Lack of stamina lightheadedness

2021-03-25

Systemic reaction (other): Still some really low pulse rates (high 30s) at the end of the day, but pulseox still good

Release 6 — day 14, dose 1

2021-04-04

Symptoms: Rash on injection site creeping toward bicep. Hot skin but lower than normal core temp. 96.2, no fever.

Release 7 — day 7, dose 2

2021-04-26

Systemic reaction (other): Tiny red hard bumps, started at ankle, working up leg. Like tiny blisters, some clumped together some not. Not super itchy but unlike any other rash I've had

Release 8 — day 14, dose 2

2021-05-03

Symptoms: Itchy rash on back and, oddly enough, both ankles. Had to cancel some activities.

Release 8 — day 35, dose 2

2021-05-24

Symptoms: Swelling on right side of jaw, affecting both back molar and right ear. Thought it might be tooth problem. Dentist says no and they have had people reporting similar after covid shots.

Healthcare visit (other): Dentist

Release 8 — day 42, dose 2

2021-05-31

Symptoms: Rash continues and seems not to be improving. Problems with jaw/ear dentist office believes are lymphnode inflammation.

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	Dental discomfort	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Ear disorder	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Jaw disorder	✓	✓	✓
SD	Lymphadenitis	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Swelling face	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Heart rate decreased	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Rash vesicular	✓	✓	✓

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