3D5-49774-31564

3 vaccinations 14 coded responses 19 check-ins 14 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 532 / WI
Registered: 2021-02-23

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

2021-02-23
Registered in v-safe
2021-02-23
Dose 1 — Moderna
2021-02-23
Survey response — day 0, dose 1
MedDRA: Cough, Oropharyngeal pain, Photophobia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Senstive to light, slight sore thoart and cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Survey response — day 7, dose 1
MedDRA: Cough, Pre-existing disease, Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Had to use relief inhaler and had to take coricidin for chest congwstion and coigh

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 14, dose 1
MedDRA: Chills, Epistaxis, Hyperhidrosis, Musculoskeletal chest pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Swearty, aches ribs cage on both sides are sore. Mucus has little spots of blood. Chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 21, dose 1
MedDRA: Ocular hyperaemia, Pruritus — Feeling: Fair · Be unable to work

Free text: Had red eyes and red, itching on back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Dose 2 — Moderna
2021-05-26
Survey response — 3 months, dose 1
MedDRA: Dysgeusia, Lymph node pain, Lymphadenopathy — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have sawllon lump nodes. It feel like mumps. Painfull. Hurts, if I massage them I get a bitter taste in my mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-29
Survey response — 6 months, dose 1
MedDRA: Chills, Epistaxis, Headache, Hyperhidrosis, Lymphadenopathy, Night sweats, Office visit, Oropharyngeal pain — 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 · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Sweats, and noght sweats; sore throat, headache, and chills. Nose bleeds. Clothes were soak with sweat. Had very huge lump uder my right jaw lymp note. · Healthcare visit (other): Seen by primeary care doctor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Report sent to call center — 6 months, dose 1
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)
2021-08-31
Call 1 — Left Voicemail
2021-09-13
Dose 3 — Moderna
2021-09-13
Survey response — day 0, dose 3
MedDRA: Injection site pain, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Site of injection sore and painful slightly swollen.

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in jaw, Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Achy itchy soreness in jaw under right ear

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in jaw — Feeling: Fair · Site: Swelling, Itching · Joint pains, Nausea · Be unable to do your normal daily activities

Free text: Soreness under right jaw

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Survey response — days 1–6 daily, dose 3
MedDRA: Diarrhoea, Unevaluable event — Feeling: Good · Site: Swelling, Itching · Headache, Diarrhea · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Loose bowels · Healthcare visit (other): followed insteucrions given earlier

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-20
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Swelling · Nausea, Diarrhea

Adult check-in
2021-09-21
Call 1 — Left Voicemail
2021-09-28
Survey response — day 14, dose 3
MedDRA: Abdominal discomfort, Dizziness, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Have nausea upset stomach. Feel faint. Sometimes.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-11
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-18
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-25
Survey response — day 42, dose 3
MedDRA: Diarrhoea, Headache, Nausea, Oropharyngeal pain, Purpura — Feeling: Fair · Be unable to work or attend school

Free text: Diarrhea, sore throat, blood spots and nausea with headaches

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Survey response — 3 months, dose 3
MedDRA: Abdominal pain upper, Office visit, Sinus pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Pain in sinuses and stomacj · Healthcare visit (other): Inner office visit first 12/17

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-12-22
Call 1 — Could Not Reach Participant
2021-12-27
Call 2 — Left Voicemail
2022-03-14
Survey response — 6 months, dose 3
MedDRA: Body temperature abnormal, Cough, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, 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: Symptoms: I keep a slightly sallowen gland uhder my jaw by right ear. My food do not taste the same. I was told my physican I probably most likely had COVID before it was diagnosed. Due to the many symptoms I had. About 1 and half later COVID was announced. · Healthcare visit (other): I can get rid of a night cough. Body temputure is off. Ut I glad I got the vaccine. I think it could be worst.

MedDRA releases: 2024-11 · check-in free text available
2022-03-14
Report sent to call center — 6 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-26	Moderna	No
3	2021-09-13	Moderna	No

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-23

Systemic reaction (other): Senstive to light, slight sore thoart and cough

Release 5 — day 7, dose 1

2021-03-07

Systemic reaction (other): Had to use relief inhaler and had to take coricidin for chest congwstion and coigh

Release 5 — day 14, dose 1

2021-03-10

Symptoms: Swearty, aches ribs cage on both sides are sore. Mucus has little spots of blood. Chills

Release 5 — day 21, dose 1

2021-03-17

Symptoms: Had red eyes and red, itching on back

Release 8 — 3 months, dose 1

2021-05-26

Symptoms: I have sawllon lump nodes. It feel like mumps. Painfull. Hurts, if I massage them I get a bitter taste in my mouth

Release 9 — 6 months, dose 1

2021-08-29

Symptoms: Sweats, and noght sweats; sore throat, headache, and chills. Nose bleeds. Clothes were soak with sweat. Had very huge lump uder my right jaw lymp note.

Healthcare visit (other): Seen by primeary care doctor

Release 9 — day 0, dose 3

2021-09-13

Systemic reaction (other): Site of injection sore and painful slightly swollen.

Release 9 — days 1–6 daily, dose 3

2021-09-16

Systemic reaction (other): Achy itchy soreness in jaw under right ear

2021-09-17

Systemic reaction (other): Soreness under right jaw

2021-09-19

Systemic reaction (other): Loose bowels

Healthcare visit (other): followed insteucrions given earlier

Release 9 — day 14, dose 3

2021-09-28

Symptoms: Have nausea upset stomach. Feel faint. Sometimes.

Release 10 — day 42, dose 3

2021-10-25

Symptoms: Diarrhea, sore throat, blood spots and nausea with headaches

Release 10 — 3 months, dose 3

2021-12-20

Symptoms: Pain in sinuses and stomacj

Healthcare visit (other): Inner office visit first 12/17

Release 11 — 6 months, dose 3

2022-03-14

Symptoms: I keep a slightly sallowen gland uhder my jaw by right ear. My food do not taste the same. I was told my physican I probably most likely had COVID before it was diagnosed. Due to the many symptoms I had. About 1 and half later COVID was announced.

Healthcare visit (other): I can get rid of a night cough. Body temputure is off. Ut I glad I got the vaccine. I think it could be worst.

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	Body temperature abnormal	·	·	✓
HCVO	Cough	·	·	✓
HCVO	Office visit	✓	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal discomfort	·	·	✓
SD	Abdominal pain upper	·	·	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysgeusia	✓	✓	✓
SD	Epistaxis	✓	✓	✓
SD	Headache	✓	·	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Lymph node pain	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Nausea	·	·	✓
SD	Night sweats	✓	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Purpura	·	·	✓
SD	Sinus pain	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Diarrhoea	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in jaw	·	·	✓
SRO	Photophobia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Respiratory tract congestion	✓	✓	✓

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