382-29357-91697

4 vaccinations 10 coded responses 38 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 017 / MA
Registered: 2021-03-03

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

2021-03-02
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Asthma, Bronchiectasis, Dyspnoea — Feeling: Fair · Fatigue or tiredness

Free text: My breathing issues seem to have increased. I have asthma and Bronchiectasis so its difficult to say why.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Tinnitus — Feeling: Good

Free text: I forgot to mention on the day after my 2nd shot I had an increase of ringing in my ears.

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

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 14, dose 2
MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increase in my asthma, with no apparent cause.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-08
Dose 3 — Moderna
2022-03-30
Survey response — 12 months, dose 2
MedDRA: Cough, Irritability — Feeling: Fair

Free text: Nagging dry cough

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Dose 4 — Moderna
2022-06-10
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain

Free text: Two swellings in the lymph nodes on the back of my neck, left side; Since I received the injection.

MedDRA releases: 2024-11 · check-in free text available
2022-06-11
Survey response — days 1–6 daily, dose 4
MedDRA: Swelling, Tenderness — Feeling: Fair · Fatigue or tiredness

Free text: Still experiencing swelling under the left occipital lobe. Tender to touch.

MedDRA releases: 2024-11 · check-in free text available
2022-06-12
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Swelling all around the lymph nodes on the Left side of my head.

MedDRA releases: 2024-11 · check-in free text available
2022-06-12
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-13
Survey response — days 1–6 daily, dose 4
MedDRA: Headache, Swelling — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pain and swelling on left side of head

MedDRA releases: 2024-11 · check-in free text available
2022-06-13
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-13
Call 1 — Left Voicemail
2022-06-14
Call 1 — Left Voicemail
2022-06-15
Survey response — day 7, dose 4
MedDRA: Headache, Pruritus, Swelling — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Pain swelling and itchiness on the left side of my head.

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-07
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-07
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-06-08
Survey response — 12 months, dose 4
MedDRA: Chills, Cough, Pain, Pyrexia, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-11-08	Moderna	No
4	2022-06-08	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): My breathing issues seem to have increased. I have asthma and Bronchiectasis so its difficult to say why.

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): I forgot to mention on the day after my 2nd shot I had an increase of ringing in my ears.

Release 7 — day 14, dose 2

2021-04-13

Symptoms: Increase in my asthma, with no apparent cause.

Release 11 — 12 months, dose 2

2022-03-30

Symptoms: Nagging dry cough

Release 12 — days 1–6 daily, dose 4

2022-06-10

Systemic reaction (other): Two swellings in the lymph nodes on the back of my neck, left side; Since I received the injection.

2022-06-11

Systemic reaction (other): Still experiencing swelling under the left occipital lobe. Tender to touch.

2022-06-12

Systemic reaction (other): Swelling all around the lymph nodes on the Left side of my head.

2022-06-13

Systemic reaction (other): Pain and swelling on left side of head

Release 12 — day 7, dose 4

2022-06-15

Systemic reaction (other): Pain swelling and itchiness on the left side of my head.

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	Asthma	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Irritability	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Asthma	✓	✓	✓
SRO	Bronchiectasis	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Swelling	·	·	✓
SRO	Tenderness	·	·	✓
SRO	Tinnitus	✓	✓	✓

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