3NC-23509-89939

4 vaccinations 15 coded responses 30 check-ins 15 free-text entries 0 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 907 / CA
Registered: 2021-01-23

Relationship: Self
Race: White
Ethnicity: 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

2021-01-20
Dose 1 — Moderna
2021-01-23
Registered in v-safe
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Rash — Feeling: Fair

Free text: Redness, bump, itching, warm to the touch and ring around rash on arm at the injection site is slowly subsiding. No OTCs taken. Cold compress applied. Rash appeared on 1/28/21. COVID-19 vaccine administered on 1/20/21. PCP also notified.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy spells, ringing in the ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Tinnitus — Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite, ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Ear discomfort, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Frequent ringing in the ears and the sensation of fullness in the ears

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-29
Dose 3 — Moderna
2022-02-19
Survey response — 12 months, dose 2
MedDRA: Menstruation irregular, Muscular weakness, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Arm in which vaccine was administered experiences occasional weakness and pain. Also Experiencing irregular periods.

MedDRA releases: 2024-11 · check-in free text available
2022-09-12
Dose 4 — Moderna
2022-09-15
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Ear discomfort, Palpitations, Tinnitus — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Fullness and ringing in the ears, primarily on the side where the vaccine was administered. Occasional heart palpitations. Dizziness.

MedDRA releases: 2024-11 · check-in free text available
2022-09-16
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Ear discomfort, Ear pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school

Free text: Ear fullness and pain. Dizziness.

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Survey response — days 1–6 daily, dose 4
MedDRA: Ear pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Ear aches

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Survey response — days 1–6 daily, dose 4
MedDRA: Ear congestion, Ear pain — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Left ear pain and stuffiness

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2022-10-03
Survey response — day 21, dose 4
MedDRA: Costochondritis, Emergency care — Feeling: Fair · Be unable to work or attend school

Free text: ER visit for costochondritis

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Survey response — day 35, dose 4
MedDRA: Menstruation delayed — Feeling: Fair

Free text: Delayed menses. First day of my last period was August 26, 2022. Received Covid booster on 9/12/22. Not pregnant.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Survey response — day 42, dose 4
MedDRA: Menstruation irregular — Feeling: Good

Free text: Missed period. I'm not pregnant.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-12-29	Moderna	No
4	2022-09-12	Moderna	No

Free text

Release 3 — day 14, dose 1

2021-02-03

Symptoms: Redness, bump, itching, warm to the touch and ring around rash on arm at the injection site is slowly subsiding. No OTCs taken. Cold compress applied. Rash appeared on 1/28/21. COVID-19 vaccine administered on 1/20/21. PCP also notified.

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Dizzy spells, ringing in the ears

2021-02-21

Systemic reaction (other): Loss of appetite, ringing in ears

2021-02-22

Systemic reaction (other): Migraine

2021-02-23

Systemic reaction (other): Ringing in ears

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): Ringing in ears

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Frequent ringing in the ears and the sensation of fullness in the ears

Release 11 — 12 months, dose 2

2022-02-19

Symptoms: Arm in which vaccine was administered experiences occasional weakness and pain. Also Experiencing irregular periods.

Release 12 — days 1–6 daily, dose 4

2022-09-15

Systemic reaction (other): Fullness and ringing in the ears, primarily on the side where the vaccine was administered. Occasional heart palpitations. Dizziness.

2022-09-16

Systemic reaction (other): Ear fullness and pain. Dizziness.

2022-09-17

Systemic reaction (other): Ear aches

2022-09-18

Systemic reaction (other): Left ear pain and stuffiness

Release 12 — day 21, dose 4

2022-10-03

Symptoms: ER visit for costochondritis

Release 12 — day 35, dose 4

2022-10-17

Symptoms: Delayed menses. First day of my last period was August 26, 2022. Received Covid booster on 9/12/22. Not pregnant.

Release 12 — day 42, dose 4

2022-10-26

Symptoms: Missed period. I'm not pregnant.

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	Costochondritis	·	·	✓
SD	Ear discomfort	✓	·	✓
SD	Emergency care	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Menstruation delayed	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Rash	✓	✓	✓
SD	Tinnitus	✓	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear congestion	·	·	✓
SRO	Ear discomfort	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Migraine	✓	✓	✓
SRO	Palpitations	·	·	✓
SRO	Tinnitus	✓	✓	✓

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