4ZS-70682-69260

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 504 / IA
Registered: 2020-12-29

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Carpal tunnel syndrome — Feeling: Good · Site: Pain

Free text: Mild carpal tunnel syndrome in same arm as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Very minor pain in arm now- almost resolved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Survey response — day 21, dose 1
MedDRA: Cough, Nasal congestion, Pain, Paranasal sinus hypersecretion, Respiratory tract congestion, SARS-CoV-2 test negative, Throat irritation — Feeling: Fair

Free text: I developed nasal congestion with drainage, scratchy throat, mild body aches, and mildly congested cough approximately four days ago. I tested negative for covid and influenza yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
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, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Influenza virus test negative, SARS-CoV-2 test negative, Sinus congestion — Feeling: Good · Site: Pain · Fever · Chills, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Sinus congestion and dry cough x2 weeks; tested neg for covid and influenza on 1/18/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Sinus congestion — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

Free text: Sinus congestion and dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Sinus congestion — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Sinus congestion and dry cough (unrelated to shot)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Respiratory tract congestion — Feeling: Good · Site: Pain · Headache

Free text: Still having concurrent sinus congestion and dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — day 7, dose 2
MedDRA: Haemorrhage, Sinus congestion — Feeling: Good · Headache, Muscle or body aches

Free text: Sinus congestion/bleeding which is probably unrelated to vaccine.

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

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-26
Survey response — 12 months, dose 2
MedDRA: Nasal congestion, Paranasal sinus haemorrhage — Feeling: Good

Free text: Nasal congestion with bleeding sinuses x2 weeks

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Mild carpal tunnel syndrome in same arm as injection

2021-01-01

Systemic reaction (other): Very minor pain in arm now- almost resolved.

Release 2 — day 21, dose 1

2021-01-19

Symptoms: I developed nasal congestion with drainage, scratchy throat, mild body aches, and mildly congested cough approximately four days ago. I tested negative for covid and influenza yesterday.

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Sinus congestion and dry cough x2 weeks; tested neg for covid and influenza on 1/18/21

2021-01-30

Systemic reaction (other): Sinus congestion and dry cough

2021-01-31

Systemic reaction (other): Sinus congestion and dry cough (unrelated to shot)

2021-02-01

Systemic reaction (other): Still having concurrent sinus congestion and dry cough

Release 3 — day 7, dose 2

2021-02-02

Systemic reaction (other): Sinus congestion/bleeding which is probably unrelated to vaccine.

Release 11 — 12 months, dose 2

2022-01-26

Symptoms: Nasal congestion with bleeding sinuses x2 weeks

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	Nasal congestion	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Paranasal sinus haemorrhage	·	·	✓
SD	Paranasal sinus hypersecretion	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SRO	Carpal tunnel syndrome	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Haemorrhage	✓	✓	✓
SRO	Influenza virus test negative	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓

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