3AM-13684-91472

3 vaccinations 10 coded responses 29 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 982 / WA
Registered: 2021-02-09

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
Dose 1 — Moderna
2021-02-09
Registered in v-safe
2021-02-09
Dose 2 — Moderna
2021-02-09
Survey response — day 0, dose 2
MedDRA: Ear pain, Head discomfort — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Head fullness, ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Head discomfort — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Ear pain, head fullness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Head discomfort — Feeling: Poor · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Ear pain, head fullness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
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: Aphasia, Headache, Nausea, Vomiting — Feeling: Fair · Be unable to work, 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: Concussion related headaches, nausea, vomiting and word-finding difficulty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-09
Survey response — day 28, dose 2
MedDRA: Aphasia, Headache, Nausea, Post concussion syndrome — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Post concussion syndrome headaches, nausea and word find problems.

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
2021-03-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Cough, Dyspnoea, Respiratory tract congestion, Wheezing — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Shortness of breath, wheezing, coughing, congestion

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Report sent to call center — 6 months, dose 2
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)
2021-08-11
Call 1 — Left Voicemail
2021-10-23
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-20
Survey response — day 28, dose 3
MedDRA: Asthma, Nasopharyngitis, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Asthma exacerbation, mild cold symptoms, Covid negative

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-24
Call 1 — Could Not Reach Participant
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-01
Call 2 — Could Not Reach Participant
2021-12-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-22
Survey response — 3 months, dose 3
MedDRA: Nasopharyngitis, Sinusitis — Feeling: Fair · Be unable to work or attend school

Free text: Sinus infection, cold symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Survey response — 6 months, dose 3
MedDRA: Drug hypersensitivity, Nasopharyngitis, Rash pruritic, Sinus pain — Feeling: Fair

Free text: Allergic reaction to OTC menopause support supplement-rash, itching Cold with sinus pain

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-10-23	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): Head fullness, ear pain

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Ear pain, head fullness

2021-02-11

Systemic reaction (other): Ear pain, head fullness

2021-02-12

Systemic reaction (other): Ear pain

Release 4 — day 21, dose 2

2021-03-02

Symptoms: Concussion related headaches, nausea, vomiting and word-finding difficulty

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Post concussion syndrome headaches, nausea and word find problems.

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Shortness of breath, wheezing, coughing, congestion

Release 10 — day 28, dose 3

2021-11-20

Symptoms: Asthma exacerbation, mild cold symptoms, Covid negative

Release 11 — 3 months, dose 3

2022-01-22

Symptoms: Sinus infection, cold symptoms

Release 11 — 6 months, dose 3

2022-04-24

Symptoms: Allergic reaction to OTC menopause support supplement-rash, itching Cold with sinus pain

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	Aphasia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Cough	✓	·	✓
SD	Drug hypersensitivity	·	·	✓
SD	Dyspnoea	✓	·	✓
SD	Headache	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Post concussion syndrome	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Respiratory tract congestion	✓	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	·	·	✓
SD	Vomiting	✓	✓	✓
SD	Wheezing	✓	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Head discomfort	✓	✓	✓

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