5QN-10344-96119

2 vaccinations 7 coded responses 18 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 601 / IL
Registered: 2021-06-04

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

2021-06-03
Dose 1 — Moderna
2021-06-04
Registered in v-safe
2021-06-05
Survey response — days 1–6 daily, dose 1
MedDRA: Epistaxis, Lip pain, Nasal congestion, Oral herpes, Rhinorrhoea, Sneezing — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: I still have the fever blister sore on my top lip which developed the evening of my vaccination day. The nasal congestion and running nose that started yesterday has decreased along with the nose bleed. It seems as if the nose bleeding was coming from capillaries within the nasal cavity, which not not running but notice when I would wipe inside my nose. That has stopped today and no running nose although I continue to sneeze. Oh I forgot to mention yesterday that the sneezing started in the day of the vaccine. nose t

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-06
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle twitching, Oral herpes, Pain, Rhinalgia, Rhinorrhoea, Sneezing, Tenderness — Feeling: Good · Site: Pain · Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Minor pain occasionally from the fever blister and pain a d tenderness around entire the nose. Still some muscle twitching in the mouth area at night and early morning. Fever blister started forming scalp toda sti some pain and soarnrss around that but minor. Taking Nasacort now for nose sniffles and sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Survey response — days 1–6 daily, dose 1
MedDRA: Medical counselling, Nasal inflammation, Rhinalgia — Feeling: Good · Site: Pain · Joint pains · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Just soreness around the nose, the entire nasal cavity appears to be inflamed and sore. Other than that, Im doing fine. · Healthcare visit (other): Not sure if I mentioned this before, but I did call my doctor on day 2 to get nasacort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Survey response — days 1–6 daily, dose 1
MedDRA: Inflammation, Oral herpes, Tenderness — Feeling: Good

Free text: Nose still a bit inflamed and tender but no pain. Also fever blister still healing I know conventional wisdom days these are not resulting from the vaccine but the reality is, I was in my doctors office 1 hour prior to vaccine for routine exam, healthy with no symptoms nor indication of any of these 2. So perhaps CDC should be looking at correlations instead of just causality since its clear to me the vaccine triggered something in my body that led to the cold/flu like symptoms and the fever blister on mouth and nose bleeding. No history at all of nose bleeding that was new to me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — day 7, dose 1
MedDRA: Chills, Haemoglobin decreased, Oral herpes — Feeling: Good · Chills

Free text: Just the nasty fever blister. Also I dont think the chills is from the vaccine though I have a mildly low hemoglobin rate and was periodically having chills in my bones before the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-07-01
Dose 2 — Moderna
2021-07-01
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-07-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-07-07
Survey response — days 1–6 daily, dose 2
MedDRA: Joint swelling — Feeling: Good

Free text: I actually had no symptoms after my 2nd shot. Earlier I reported joint swelling but it was actually ankle swelling that was related to me doing over 13K steps that day on hard wooed floors that happened before apart from vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-07-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Call 2 — Left Voicemail
2021-11-16
Call 3 — Left Voicemail
2022-07-01
Survey response — 12 months, dose 2
MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Potential food poising

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-03	Moderna
2	2021-07-01	Moderna	No

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 1

2021-06-05

Systemic reaction (other): I still have the fever blister sore on my top lip which developed the evening of my vaccination day. The nasal congestion and running nose that started yesterday has decreased along with the nose bleed. It seems as if the nose bleeding was coming from capillaries within the nasal cavity, which not not running but notice when I would wipe inside my nose. That has stopped today and no running nose although I continue to sneeze. Oh I forgot to mention yesterday that the sneezing started in the day of the vaccine. nose t

2021-06-06

Systemic reaction (other): Minor pain occasionally from the fever blister and pain a d tenderness around entire the nose. Still some muscle twitching in the mouth area at night and early morning. Fever blister started forming scalp toda sti some pain and soarnrss around that but minor. Taking Nasacort now for nose sniffles and sneezing

2021-06-07

Systemic reaction (other): Just soreness around the nose, the entire nasal cavity appears to be inflamed and sore. Other than that, Im doing fine.

Healthcare visit (other): Not sure if I mentioned this before, but I did call my doctor on day 2 to get nasacort.

2021-06-08

Systemic reaction (other): Nose still a bit inflamed and tender but no pain. Also fever blister still healing I know conventional wisdom days these are not resulting from the vaccine but the reality is, I was in my doctors office 1 hour prior to vaccine for routine exam, healthy with no symptoms nor indication of any of these 2. So perhaps CDC should be looking at correlations instead of just causality since its clear to me the vaccine triggered something in my body that led to the cold/flu like symptoms and the fever blister on mouth and nose bleeding. No history at all of nose bleeding that was new to me.

Release 9 — day 7, dose 1

2021-06-10

Systemic reaction (other): Just the nasty fever blister. Also I dont think the chills is from the vaccine though I have a mildly low hemoglobin rate and was periodically having chills in my bones before the vaccine.

Release 9 — days 1–6 daily, dose 2

2021-07-07

Systemic reaction (other): I actually had no symptoms after my 2nd shot. Earlier I reported joint swelling but it was actually ankle swelling that was related to me doing over 13K steps that day on hard wooed floors that happened before apart from vaccination.

Release 12 — 12 months, dose 2

2022-07-01

Symptoms: Potential food poising

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	Unevaluable event	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Haemoglobin decreased	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Lip pain	✓	✓	✓
SRO	Muscle twitching	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasal inflammation	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Rhinalgia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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