3RJ-11381-90584

3 vaccinations 9 coded responses 28 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 108 / NY
Registered: 2021-03-13

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-09
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Good

Free text: Runny nose, congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — day 7, dose 1
MedDRA: Seasonal allergy — Feeling: Good

Free text: Seasonal allergies - (AM)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-06
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Its still early - received shot around 10:20 am

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: A little foggy this morning- better now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Palpitations — Feeling: Good · Site: Redness, Itching

Free text: Foggy - some palpitations but feeling better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Fatigue, Swelling — Feeling: Good · Site: Redness, Swelling

Free text: Minor redness and swelling almost gone. Ive been tired - cap naps are not enough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, dose 2
MedDRA: Injection site pain, Self-medication — Feeling: Fair

Free text: My arm is hurting at the injection area. Weird Its been hurting for 3 days. Tylenol not helping. No fever or any other concerns. Perhaps its unrelated but it feels like I got another shot?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-20
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Sensory disturbance — Feeling: Good

Free text: Had sensation on left side in tight area, wrist, and chest. Lasted most of the day then stopped.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-17
Dose 3 — Moderna
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-12-27
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-31
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
2022-01-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-20
Survey response — 3 months, dose 3
MedDRA: Glaucoma — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Glaucoma

MedDRA releases: 2024-11 · check-in free text available
2022-03-20
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-06-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-21
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-12-17	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): Runny nose, congestion

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): Seasonal allergies - (AM)

Release 7 — day 0, dose 2

2021-04-06

Systemic reaction (other): Its still early - received shot around 10:20 am

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): A little foggy this morning- better now

2021-04-09

Systemic reaction (other): Foggy - some palpitations but feeling better

2021-04-11

Systemic reaction (other): Minor redness and swelling almost gone. Ive been tired - cap naps are not enough

Release 8 — day 21, dose 2

2021-04-27

Symptoms: My arm is hurting at the injection area. Weird Its been hurting for 3 days. Tylenol not helping. No fever or any other concerns. Perhaps its unrelated but it feels like I got another shot?

Release 8 — day 42, dose 2

2021-05-20

Symptoms: Had sensation on left side in tight area, wrist, and chest. Lasted most of the day then stopped.

Release 11 — 3 months, dose 3

2022-03-20

Symptoms: Glaucoma

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	Chest discomfort	✓	✓	✓
SD	Glaucoma	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sensory disturbance	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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