3DS-10406-34824

3 vaccinations 9 coded responses 29 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 786 / TX
Registered: 2021-03-04

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-26
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-12
Survey response — day 14, dose 1
MedDRA: Axillary pain, Pre-existing disease — Feeling: Good

Free text: Ive had pain on my underarm . It comes and goes. Not sure if related. Never had this pain before. I wonder what type of side effects I might experience since I suffer from a form of vasculitis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Dose 2 — Moderna
2021-03-26
Survey response — day 0, dose 2
MedDRA: Fatigue, Headache, Pain in extremity — Feeling: Fair · Site: Pain · Headache, Joint pains

Free text: Slight headache and pain on the arm. Also fatigued leggs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Headache

Free text: Still have pain on the first site. A lingering burning feeling and pain. Pain to touch as well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Still feel burning sensation and slight pain on the site of the first shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · 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 · None

Adult check-in
2021-04-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Survey response — 3 months, dose 2
MedDRA: Office visit, Retinal vascular occlusion, Retinal vein occlusion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Eye occlusion · Healthcare visit (other): Doctors Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-30
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-05
Call 1 — Could Not Reach Participant
2021-07-09
Call 2 — Could Not Reach Participant
2021-09-26
Survey response — 6 months, dose 2
MedDRA: Office visit, Retinal vascular occlusion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Retina eye occlusion. · Healthcare visit (other): Retina specialist

MedDRA releases: 2024-11 · check-in free text available
2021-09-26
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-28
Call 1 — Could Not Reach Participant
2021-10-01
Call 2 — Could Not Reach Participant
2021-10-01
Callback requested for
2021-10-25
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Headache

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Survey response — day 28, dose 3
MedDRA: Cataract operation, Retinal operation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had Retina and cataract surgeries. Felling ok. No COVID-19 related symptoms.

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-25
Survey response — 6 months, dose 3
MedDRA: Rosacea — Feeling: Good

Free text: Rosecea

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-10-25	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Ive had pain on my underarm . It comes and goes. Not sure if related. Never had this pain before. I wonder what type of side effects I might experience since I suffer from a form of vasculitis.

Release 6 — day 0, dose 2

2021-03-26

Systemic reaction (other): Slight headache and pain on the arm. Also fatigued leggs.

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): Short of breath

2021-03-28

Systemic reaction (other): Still have pain on the first site. A lingering burning feeling and pain. Pain to touch as well.

2021-03-29

Systemic reaction (other): Still feel burning sensation and slight pain on the site of the first shot

Release 9 — 3 months, dose 2

2021-06-30

Symptoms: Eye occlusion

Healthcare visit (other): Doctors Office visit

Release 9 — 6 months, dose 2

2021-09-26

Symptoms: Retina eye occlusion.

Healthcare visit (other): Retina specialist

Release 10 — day 28, dose 3

2021-11-23

Symptoms: Had Retina and cataract surgeries. Felling ok. No COVID-19 related symptoms.

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: Rosecea

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	Axillary pain	✓	✓	✓
SD	Cataract operation	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Retinal operation	·	·	✓
SD	Retinal vascular occlusion	✓	·	✓
SD	Retinal vein occlusion	○	✓	○
SD	Rosacea	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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