4DB-32489-12935

3 vaccinations 13 coded responses 40 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 462 / IN
Registered: 2021-01-07

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

Timeline

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling

Free text: Sore throat,mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Site: Pain, Swelling

Free text: Mild Tightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Survey response — day 7, dose 1
MedDRA: Angioedema, Pre-existing disease — Feeling: Good

Free text: Moderate Angiodema, right tongue. I experienced this before, but it's been months ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Survey response — day 0, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Angioedema, Ear discomfort, Ear swelling, Feeling hot, Pruritus — Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Moderate Angioedema in left ear. Itching , swelling, discomfort, hot to touch near the ear lobe

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

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-11
Survey response — day 7, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Free text: Mild sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 21, dose 2
MedDRA: Urticaria — Feeling: Fair

Free text: Moderate, intermittent, hives, various body parts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-19
Survey response — day 42, dose 2
MedDRA: Angioedema, Pre-existing disease, Pruritus, Swelling, Urticaria — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Multiple Angiodema flares, itching, hives, swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Survey response — 6 months, dose 2
MedDRA: Myalgia — Feeling: Good

Free text: Muscle pain in upper arms. 1st dose was in right arm, 2nd dose was in left arm.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-13
Dose 3 — Moderna
2022-05-13
Survey response — day 0, dose 3
MedDRA: Injection site pain, Reaction to previous exposure to any vaccine — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Site of booster is very sore. The worst of 3

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Report sent to call center — day 0, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-16
Call 1 — Left Voicemail
2022-05-17
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Good · Headache, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Call 2 — Left Voicemail
2022-05-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-23
Health check-in — day 7, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-05-27
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-06-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-08-12
Survey response — 3 months, dose 3
MedDRA: Headache, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat. Headaches. Possible sinusitis

MedDRA releases: 2024-11 · check-in free text available
2022-08-12
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-15
Call 3 — Left Voicemail
2022-08-15
Call 1 — Left Voicemail
2022-11-11
Survey response — 6 months, dose 3
MedDRA: Asthenia, Headache — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headaches, low energy, sinus infection?

MedDRA releases: 2024-11 · check-in free text available
2023-05-13
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2022-05-13	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-08

Systemic reaction (other): Sore throat,mild

2021-01-11

Systemic reaction (other): Mild Tightness in chest

Release 2 — day 7, dose 1

2021-01-16

Systemic reaction (other): Moderate Angiodema, right tongue. I experienced this before, but it's been months ago

Release 3 — day 0, dose 2

2021-02-04

Systemic reaction (other): Sore throat

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Moderate Angioedema in left ear. Itching , swelling, discomfort, hot to touch near the ear lobe

Release 4 — day 7, dose 2

2021-02-11

Systemic reaction (other): Mild sore throat

Release 4 — day 21, dose 2

2021-02-25

Symptoms: Moderate, intermittent, hives, various body parts

Release 5 — day 42, dose 2

2021-03-19

Symptoms: Multiple Angiodema flares, itching, hives, swelling

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: Muscle pain in upper arms. 1st dose was in right arm, 2nd dose was in left arm.

Release 11 — day 0, dose 3

2022-05-13

Systemic reaction (other): Site of booster is very sore. The worst of 3

Release 11 — days 1–6 daily, dose 3

2022-05-17

Systemic reaction (other): Sore throat

Release 12 — 3 months, dose 3

2022-08-12

Symptoms: Sore throat. Headaches. Possible sinusitis

Release 12 — 6 months, dose 3

2022-11-11

Symptoms: Headaches, low energy, sinus infection?

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	Angioedema	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Headache	·	·	✓
SD	Myalgia	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Angioedema	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Ear swelling	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓

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