5F9-23190-52822

3 vaccinations 11 coded responses 23 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 750 / TX
Registered: 2021-10-12

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

2021-10-11
Dose 1 — Moderna
2021-10-12
Registered in v-safe
2021-10-12
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: Tinnitus since about an hour after injection

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Good · Site: Pain · Headache

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-16
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Good · Site: Pain

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Tinnitus — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sore throat (probably not from the vaccine at this point); tinnitus

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Survey response — day 7, dose 1
MedDRA: Tinnitus — Feeling: Good

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-11-10
Dose 2 — Moderna
2021-11-10
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 7, dose 2
Feeling: Good · Headache, Nausea

Free text: Tinnitus

Adult check-in · check-in free text available
2021-11-26
Survey response — day 14, dose 2
MedDRA: Bronchitis, Medical counselling, SARS-CoV-2 test negative — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have bronchitis, unrelated to covid. I had a negative covid test today. · Healthcare visit (other): My son is a doctor. He confirmed my diagnosis of bronchitis. Currently visiting him.

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-01
Survey response — day 21, dose 2
MedDRA: Bronchitis, Illness, Medical counselling, Nasopharyngitis, SARS-CoV-2 test negative — 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

Free text: Symptoms: I have bronchitis, and then got a cold on top of that. Unrelated to vaccination. I had a negative covid test on the 3rd day of this illness. · Healthcare visit (other): My son is a doctor, and I was visiting him, so no office visit was necessary.

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Report sent to call center — day 21, 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)
2021-12-01
Call 1 — Left Voicemail
2021-12-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-03
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-08
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Office visit, Physiotherapy, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Flare up of psoas syndrome (painful core muscle). I've had this problem occasionally throughout my life, and it's doubtful that it would be related to vaccination. · Healthcare visit (other): Chiropractor for physical therapy

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-09
Call 1 — Left Voicemail
2021-12-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-02-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-03-31
Dose 3 — Moderna
2022-04-21
Survey response — day 21, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: For a week after the booster vaccination, I had a painful swollen lymph node under my arm on the same side as the vaccination. It has completely gone away. (It is now 22 days since that booster.I registered here late.)

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-06-30
Survey response — 3 months, dose 3
MedDRA: Bladder pain — Feeling: Good

Free text: bladder pain, not an infection, unexplained

MedDRA releases: 2024-11 · check-in free text available
2023-03-31
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-11	Moderna	No
2	2021-11-10	Moderna	No
3	2022-03-31	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 1

2021-10-12

Systemic reaction (other): Tinnitus since about an hour after injection

2021-10-13

Systemic reaction (other): Tinnitus

2021-10-14

Systemic reaction (other): Tinnitus

2021-10-16

Systemic reaction (other): Tinnitus

2021-10-17

Systemic reaction (other): Sore throat (probably not from the vaccine at this point); tinnitus

Release 10 — day 7, dose 1

2021-10-18

Systemic reaction (other): Tinnitus

Release 10 — day 14, dose 2

2021-11-26

Symptoms: I have bronchitis, unrelated to covid. I had a negative covid test today.

Healthcare visit (other): My son is a doctor. He confirmed my diagnosis of bronchitis. Currently visiting him.

Release 10 — day 21, dose 2

2021-12-01

Symptoms: I have bronchitis, and then got a cold on top of that. Unrelated to vaccination. I had a negative covid test on the 3rd day of this illness.

Healthcare visit (other): My son is a doctor, and I was visiting him, so no office visit was necessary.

Release 10 — day 28, dose 2

2021-12-08

Symptoms: Flare up of psoas syndrome (painful core muscle). I've had this problem occasionally throughout my life, and it's doubtful that it would be related to vaccination.

Healthcare visit (other): Chiropractor for physical therapy

Release 11 — day 21, dose 3

2022-04-21

Symptoms: For a week after the booster vaccination, I had a painful swollen lymph node under my arm on the same side as the vaccination. It has completely gone away. (It is now 22 days since that booster.I registered here late.)

Release 12 — day 7, dose 2

2021-11-23

Systemic reaction (other): Tinnitus

Release 12 — 3 months, dose 3

2022-06-30

Symptoms: bladder pain, not an infection, unexplained

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	Bronchitis	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
SD	Bladder pain	·	·	✓
SD	Bronchitis	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Illness	·	·	✓
SD	Lymph node pain	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Tinnitus	·	·	✓

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