3NP-20087-73446

5 vaccinations 9 coded responses 36 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 972 / OR
Registered: 2021-02-27

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

2021-02-26
Dose 1 — Moderna
2021-02-27
Registered in v-safe
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Product administered at inappropriate site — Feeling: Fair · Site: Pain · Headache, Joint pains · Be unable to do your normal daily activities

Free text: Believe injection may have been given too high and is affecting my shoulder and neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Joint range of motion decreased — Feeling: Fair · Site: Pain · Joint pains

Free text: Shoulder still catches and limited range of motion but improving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea — Feeling: Good · Diarrhea

Free text: I have had loose stools last 3 days, unsure if its related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — day 14, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Itching for 4-5 days in vaccine arm (shoulder)no significant rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
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 · Headache

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 7, 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
Survey response — day 21, dose 2
MedDRA: Cough, Paranasal sinus haemorrhage, Sinus congestion, Sinusitis — Feeling: Fair

Free text: Sinus infection/sinus bleeding congestion, slight cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 35, dose 2
MedDRA: Headache, Neck pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe head and neck pain at base of skull and up right side of head over ear into temple area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-03
Dose 3 — Moderna
2022-03-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-09
Dose 4 — Moderna
2022-09-15
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-22
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-27
Survey response — day 42, dose 5
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-12-15
Survey response — 3 months, dose 5
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Mild sore throat

MedDRA releases: 2024-11 · check-in free text available
2023-03-17
Survey response — 6 months, dose 5
MedDRA: Chills, Eye irritation, Headache, Increased upper airway secretion — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-12-03	Moderna	No
4	2022-06-09	Moderna	No
5	2022-09-15	Pfizer-BioNTech	Flu

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-28

Systemic reaction (other): Believe injection may have been given too high and is affecting my shoulder and neck.

2021-03-01

Systemic reaction (other): Shoulder still catches and limited range of motion but improving.

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): I have had loose stools last 3 days, unsure if its related

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Itching for 4-5 days in vaccine arm (shoulder)no significant rash.

Release 7 — day 21, dose 2

2021-04-16

Symptoms: Sinus infection/sinus bleeding congestion, slight cough.

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Severe head and neck pain at base of skull and up right side of head over ear into temple area.

Release 12 — day 42, dose 5

2022-10-27

Symptoms: Sore throat

Release 12 — 3 months, dose 5

2022-12-15

Symptoms: Mild sore throat

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	Eye irritation	·	·	✓
SD	Headache	✓	✓	✓
SD	Increased upper airway secretion	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus haemorrhage	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Joint range of motion decreased	✓	✓	✓
SRO	Product administered at inappropriate site	✓	✓	✓

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