5EA-10720-00695

2 vaccinations 6 coded responses 15 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 648 / MO
Registered: 2021-03-03

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

2021-02-03
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Headache, Migraine — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: It is not a normal headache or migrane. Feels like a cenent block is sitting on top of my head and there is a burning across my forehead

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing condition improved — Feeling: Good · Site: Redness

Free text: I have had pain in my body for last 12 months but today I woke up with no pain AT ALL! It started to diminish after first vaccine and now after second it gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling, Itching · Fever · Chills, Headache, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Headache severethen eased about 8pm yesterday then severe at 4am again eased at abkut 9am to moderate all day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Survey response — day 35, dose 2
MedDRA: Pain, Pre-existing condition improved — Feeling: Poor · Be unable to do your normal daily activities

Free text: The pain in my body that I had been struggling with before the vaccines that dimished with first vacine and disappeared with the second vaccine came back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Survey response — 6 months, dose 2
MedDRA: Asthenia, Chest pain, Dizziness, Nasal disorder, Pulmonary pain, SARS-CoV-2 test — Feeling: Good · 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: Symptoms: 4 weeks ago had nasal oroblems and lungs hurt lasted 5 days. Week and a half ago lungs burned and hurt, weak dizzy alot lasted 5 days. Been fine since. · Healthcare visit (other): 2 covid rapid tests

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-01
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-08
Call 1 — Left Voicemail
2022-03-09
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Dizziness, Haemorrhage, Joint swelling, Ophthalmic migraine, Uterine leiomyoma — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Pain and swelling in joints. Starting bleeding heavily after not having one for years Large fibroid tumor in uterus. Dizziness. Ocular migranes.

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
Report sent to call center — 12 months, dose 2
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 · Emergency room or emergency department visit · 1 call case(s)
2022-03-14
Call 1 — Left Voicemail
2022-03-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): It is not a normal headache or migrane. Feels like a cenent block is sitting on top of my head and there is a burning across my forehead

2021-03-05

Systemic reaction (other): I have had pain in my body for last 12 months but today I woke up with no pain AT ALL! It started to diminish after first vaccine and now after second it gone.

2021-03-08

Systemic reaction (other): Headache severethen eased about 8pm yesterday then severe at 4am again eased at abkut 9am to moderate all day

Release 7 — day 35, dose 2

2021-04-07

Symptoms: The pain in my body that I had been struggling with before the vaccines that dimished with first vacine and disappeared with the second vaccine came back.

Release 9 — 6 months, dose 2

2021-09-01

Symptoms: 4 weeks ago had nasal oroblems and lungs hurt lasted 5 days. Week and a half ago lungs burned and hurt, weak dizzy alot lasted 5 days. Been fine since.

Healthcare visit (other): 2 covid rapid tests

Release 11 — 12 months, dose 2

2022-03-09

Symptoms: Pain and swelling in joints. Starting bleeding heavily after not having one for years Large fibroid tumor in uterus. Dizziness. Ocular migranes.

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	SARS-CoV-2 test	✓	·	✓
SD	Arthralgia	·	·	✓
SD	Asthenia	✓	·	✓
SD	Chest pain	✓	·	✓
SD	Dizziness	✓	·	✓
SD	Haemorrhage	·	·	✓
SD	Joint swelling	·	·	✓
SD	Nasal disorder	✓	·	✓
SD	Ophthalmic migraine	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing condition improved	✓	✓	✓
SD	Pulmonary pain	✓	·	✓
SD	Uterine leiomyoma	·	·	✓
SRO	Burning sensation	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Pre-existing condition improved	✓	✓	✓

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