3KA-12034-12021

3 vaccinations 8 coded responses 36 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 800 / CO
Registered: 2021-04-10

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-04-10
Registered in v-safe
2021-04-10
Dose 1 — Moderna
2021-04-10
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Swelling · Joint pains

Adult check-in
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 · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoacusis, Tinnitus — Feeling: Good · Site: Itching · Diarrhea

Free text: Muffled hearing in left ear (same side as injection) and ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-08
Dose 2 — Moderna
2021-05-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoacusis, Tinnitus — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness

Free text: Intermittent muffled hearing in right ear w/ tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-07
Survey response — day 28, dose 2
MedDRA: Cough, Impaired work ability, Paranasal sinus discomfort, Paranasal sinus hypersecretion, Rhinorrhoea, SARS-CoV-2 test negative, Self-medication, Sinus congestion, Sinus headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Congested sinuses, sinus pressure, sinus headache, runny nose, slight cough from mucus drainage. Took friday off of work to rest. Had a negative covid test and a neti pot plus allergy nasal spray helped me feel better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-18
Dose 3 — Moderna
2021-12-20
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains

Free text: Covid arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Diarrhea

Free text: Covid arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Covid arm still spreading

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Swelling, Itching

Free text: Covid arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction, Skin discolouration — Feeling: Fair · Site: Itching

Free text: Covid arm - looks bruised

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

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

Adult check-in
2022-01-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-22
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-18
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-18
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Moderna
2	2021-05-08	Moderna
3	2021-12-18	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-13

Systemic reaction (other): Muffled hearing in left ear (same side as injection) and ringing in ears

Release 8 — days 1–6 daily, dose 2

2021-05-09

Systemic reaction (other): Intermittent muffled hearing in right ear w/ tinnitus

Release 8 — day 28, dose 2

2021-06-07

Symptoms: Congested sinuses, sinus pressure, sinus headache, runny nose, slight cough from mucus drainage. Took friday off of work to rest. Had a negative covid test and a neti pot plus allergy nasal spray helped me feel better

Release 10 — days 1–6 daily, dose 3

2021-12-20

Systemic reaction (other): Covid arm

2021-12-21

Systemic reaction (other): Covid arm

2021-12-22

Systemic reaction (other): Covid arm still spreading

2021-12-23

Systemic reaction (other): Covid arm

2021-12-24

Systemic reaction (other): Covid arm - looks bruised

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	Cough	✓	✓	✓
SD	Impaired work ability	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Paranasal sinus hypersecretion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinus headache	✓	✓	✓
SRO	Hypoacusis	✓	✓	✓
SRO	Immunisation reaction	·	·	✓
SRO	Skin discolouration	·	·	✓
SRO	Tinnitus	✓	✓	✓

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