583-15920-97738

3 vaccinations 6 coded responses 22 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 323 / FL
Registered: 2020-12-31

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
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 · Site: Itching · None

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-23
Survey response — day 21, dose 1
MedDRA: Headache, Paranasal sinus discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus pressure, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Dose 2 — Moderna
2021-01-29
Survey response — day 28, dose 1
MedDRA: Allergic sinusitis, Blood pressure diastolic increased, Condition aggravated, Paranasal sinus discomfort, Pre-existing disease, Sinus headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Sinus pressure/headaches but I have has seasonal sinus symptoms in the past and we have been dealing with weather changes. Also noted elevated diastolic blood pressure- white coat but was higher than before. Not sure related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-07
Survey response — day 7, dose 2
MedDRA: Upper-airway cough syndrome — Feeling: Good · Headache

Free text: Post nasal drip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 14, dose 2
MedDRA: Paranasal sinus discomfort, Sinus pain — Feeling: Good

Free text: Sinus pressure and pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Lymphadenopathy, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swollen lymph nodes in supraclavicular area and bilateral axilla, worse on the side of the vaccine (left). · Healthcare visit (other): Phone call

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Survey response — 12 months, dose 2
MedDRA: Lymphadenopathy, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swollen lymph nodes took about two months after injection to resolve. · Healthcare visit (other): Phone call

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-29
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-31
Call 1 — Requested Callback
2022-04-01
Call 2 — Could Not Reach Participant
2022-04-01
Callback requested for
03:00PM ET
2022-04-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-29	Moderna
3	2021-10-26	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 2 — day 21, dose 1

2021-01-23

Symptoms: Sinus pressure, headache

Release 3 — day 28, dose 1

2021-01-29

Symptoms: Sinus pressure/headaches but I have has seasonal sinus symptoms in the past and we have been dealing with weather changes. Also noted elevated diastolic blood pressure- white coat but was higher than before. Not sure related.

Release 3 — day 7, dose 2

2021-02-07

Systemic reaction (other): Post nasal drip

Release 4 — day 14, dose 2

2021-02-12

Symptoms: Sinus pressure and pain

Release 11 — 12 months, dose 2

2022-01-29

Symptoms: Swollen lymph nodes took about two months after injection to resolve.

Healthcare visit (other): Phone call

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Swollen lymph nodes in supraclavicular area and bilateral axilla, worse on the side of the vaccine (left).

Healthcare visit (other): Phone call

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
HCVO	Medical counselling	·	·	✓
SD	Allergic sinusitis	○	✓	○
SD	Blood pressure diastolic increased	✓	✓	✓
SD	Condition aggravated	○	✓	○
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus headache	✓	✓	✓
SD	Sinus pain	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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