3JL-20610-00147

4 vaccinations 8 coded responses 50 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 283 / NC
Registered: 2021-04-09

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Moderna
2021-04-09
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site erythema, Injection site reaction, Injection site swelling, Skin exfoliation — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Fatigue or tiredness

Free text: Redness, swelling and peeling skin in the immediate area around the injection site.

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

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold — Feeling: Good · Site: Itching

Free text: Face feels cold from the inside but does not feel cold to touch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 7, dose 1
MedDRA: Feeling cold — Feeling: Good · Site: Itching

Free text: Cold sensation in face but face is not cold to the touch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-07
Dose 2 — Moderna
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-14
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Survey response — 3 months, dose 2
MedDRA: Ear discomfort, Ear pain, Hypoacusis, Pyrexia, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Low grade fever, pain, pressure, fullness, muffled hearing and humming sound in my right ear.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-01
Call 2 — Left Voicemail
2022-01-14
Dose 3 — Moderna
2022-01-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness

Adult check-in
2022-01-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2022-01-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-01-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2022-01-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-01-21
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-01-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-04
Survey response — day 21, dose 3
MedDRA: Ear discomfort, Ear pain, Nasal congestion, Rhinorrhoea — Feeling: Good

Free text: Runny/congested nose. Pain in right ear, feels like it's plugged.

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-20
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-02-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-15
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-10
Dose 4 — Moderna
2022-11-10
Health check-in — day 0, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-11-12
Survey response — days 1–6 daily, dose 4
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Tingling sensation in both hands.

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-11-19
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-26
Survey response — day 14, dose 4
MedDRA: Chills, Cough, Dizziness, Fatigue, Headache, Nasal congestion, Pyrexia, Rhinorrhoea, Taste disorder, Throat irritation — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Fever, chills, headache, cough, runny nose, nasal congestion, scratchy throat, tiredness, light headedness, change in sense of taste

MedDRA releases: 2024-11 · check-in free text available
2022-11-26
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-28
Call 1 — Left Voicemail
2022-11-28
Call 1 — Left Voicemail
2022-12-04
Survey response — day 21, dose 4
MedDRA: Ear discomfort, Fatigue, Heart rate decreased, Nasal congestion, Respiratory tract congestion — Feeling: Fair

Free text: Head congestion, stuffy nose, plugged ears, tiredness, pulse rate lower than normal.

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-12-15
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-12-24
Health check-in — day 42, dose 4
Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Plugged ears, light headedness & headache · Healthcare visit (other): Appointment with my primary care provider.

Adult check-in · check-in free text available
2022-12-24
Call case (no matching report) — Unsuccessful
2022-12-28
Call 3 — Left Voicemail
2022-12-28
Call 2 — Left Voicemail
2022-12-28
Call 1 — Left Voicemail
2023-02-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Moderna
2	2021-05-07	Moderna
3	2022-01-14	Moderna	No
4	2022-11-10	Moderna	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Redness, swelling and peeling skin in the immediate area around the injection site.

2021-04-15

Systemic reaction (other): Face feels cold from the inside but does not feel cold to touch.

Release 7 — day 7, dose 1

2021-04-16

Systemic reaction (other): Cold sensation in face but face is not cold to the touch.

Release 9 — 3 months, dose 2

2021-08-06

Symptoms: Low grade fever, pain, pressure, fullness, muffled hearing and humming sound in my right ear.

Release 11 — day 21, dose 3

2022-02-04

Symptoms: Runny/congested nose. Pain in right ear, feels like it's plugged.

Release 12 — days 1–6 daily, dose 4

2022-11-12

Systemic reaction (other): Tingling sensation in both hands.

Release 12 — day 14, dose 4

2022-11-26

Symptoms: Fever, chills, headache, cough, runny nose, nasal congestion, scratchy throat, tiredness, light headedness, change in sense of taste

Release 12 — day 21, dose 4

2022-12-04

Symptoms: Head congestion, stuffy nose, plugged ears, tiredness, pulse rate lower than normal.

Release 12 — day 42, dose 4

2022-12-24

Symptoms: Plugged ears, light headedness & headache

Healthcare visit (other): Appointment with my primary care provider.

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	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Ear discomfort	✓	·	✓
SD	Ear pain	✓	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate decreased	·	·	✓
SD	Hypoacusis	✓	·	✓
SD	Nasal congestion	·	·	✓
SD	Pyrexia	✓	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Taste disorder	·	·	✓
SD	Throat irritation	·	·	✓
SD	Tinnitus	✓	·	✓
SRO	Feeling cold	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Skin exfoliation	✓	✓	✓

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