3GT-25909-65343

3 vaccinations 9 coded responses 21 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 245 / VA
Registered: 2021-02-16

Relationship: Self
Race: Other
Ethnicity: N/A

Timeline

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

2021-02-13
Dose 1 — Moderna
2021-02-16
Registered in v-safe
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus, Headache, Pain in extremity — Feeling: Fair · Site: Pain · Headache

Free text: Had severe headache & arm soreness Sunday eyes itching last nite & today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema of eyelid, Pruritus, Swelling of eyelid — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Itching, redness swelling of eyelids

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema of eyelid, Pruritus, Swelling of eyelid — Feeling: Fair · Headache

Free text: Itching continues more scalp today. Eyelids still swollen not as red.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus, Medical counselling, Pruritus — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Itching both scalp &eyes. · Healthcare visit (other): Calls to nurse hotline last nite & call to Urgent Care this a.m

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Survey response — day 7, dose 1
MedDRA: Pruritus, Self-medication — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Scalp Itching has not stopped. Benadryl has not helped

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Feeding disorder, Headache — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Free text: Was in bed all day yesterday. Chills,headache. Cld not eat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 28, dose 2
MedDRA: Appetite disorder, Hunger — Feeling: Fair

Free text: Have been feeling like I am hungry even if it only been an hour or so since my last meal. Started w/i week following last shot but did not consider it an issue but it has continued.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Survey response — 3 months, dose 2
MedDRA: Dysgeusia — Feeling: Fair

Free text: I seem to have a sour taste in my mouth. Started after 2nd shot but didn't give it much thought but it hasn't left.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-12
Survey response — 6 months, dose 2
MedDRA: Cough, Dizziness, Fatigue — Feeling: Fair

Free text: Tired. Still have slight cough. Felt lightheaded a few times in the last few days.

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Dose 3 — Moderna

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-10-25	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): Had severe headache & arm soreness Sunday eyes itching last nite & today

2021-02-17

Systemic reaction (other): Itching, redness swelling of eyelids

2021-02-18

Systemic reaction (other): Itching continues more scalp today. Eyelids still swollen not as red.

2021-02-19

Systemic reaction (other): Itching both scalp &eyes.

Healthcare visit (other): Calls to nurse hotline last nite & call to Urgent Care this a.m

Release 4 — day 7, dose 1

2021-02-20

Systemic reaction (other): Scalp Itching has not stopped. Benadryl has not helped

Release 5 — days 1–6 daily, dose 2

2021-03-15

Systemic reaction (other): Was in bed all day yesterday. Chills,headache. Cld not eat

Release 7 — day 28, dose 2

2021-04-10

Symptoms: Have been feeling like I am hungry even if it only been an hour or so since my last meal. Started w/i week following last shot but did not consider it an issue but it has continued.

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: I seem to have a sour taste in my mouth. Started after 2nd shot but didn't give it much thought but it hasn't left.

Release 9 — 6 months, dose 2

2021-09-12

Symptoms: Tired. Still have slight cough. Felt lightheaded a few times in the last few days.

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	Medical counselling	✓	✓	✓
SD	Appetite disorder	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysgeusia	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Hunger	✓	✓	○
SRO	Chills	✓	✓	✓
SRO	Erythema of eyelid	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Feeding disorder	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Swelling of eyelid	✓	✓	✓

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