5TH-25686-87278

2 vaccinations 8 coded responses 17 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 324 / FL
Registered: 2021-03-10

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

2021-03-07
Dose 1 — Moderna
2021-03-10
Registered in v-safe
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Aphasia, Chills, Ear pain, Feeling abnormal, Hyperhidrosis — Feeling: Fair · Site: Itching · Fever · Chills, Diarrhea, Abdominal pain

Free text: Head fogginess, problems remembering pets names, husband's name, aphasia ..difficult with words.. chills and sweating, left ear pain .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-24
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-28
Dose 2 — Pfizer-BioNTech
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Survey response — day 21, dose 1
MedDRA: Abdominal pain, Arthralgia, Bursitis, Confusional state, Fatigue, Feeling abnormal, Injection site erythema, Injection site warmth, Memory impairment — Feeling: Poor · Be unable to do your normal daily activities

Free text: Joint paint, bursitis in my elbow, redness & warmth around injection site, abdominal pain, fatigue, confusion or fogginess and forgetfulness..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-10
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Poor · Joint pains · Be unable to do your normal daily activities

Free text: EAR RINGING !! DRIVING ME INSANE!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 14, dose 2
MedDRA: Tinnitus — Feeling: Poor · Be unable to do your normal daily activities

Free text: Loud screeching noise in both ears

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

Adult check-in
2021-04-26
Survey response — day 28, dose 2
MedDRA: Arthralgia, Tinnitus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Severe high pitched ringing in both ears.. joint pain in elbows, wrist and knees! Noise won't stop! maddening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-09
Survey response — day 42, dose 2
MedDRA: Suicidal ideation — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: I want to kill myself.. I've gone crazy .. vaccine is shit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Contusion, Dysphonia, Fatigue, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, hoarse voice, extensive bruising! Eccymosis?Fatigued!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-28
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-03-31
Survey response — 12 months, dose 2
MedDRA: Tinnitus — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Ringing in the ears. Tinnitus! Its maddening..

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-07	Moderna
2	2021-03-28	Pfizer-BioNTech

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Head fogginess, problems remembering pets names, husband's name, aphasia ..difficult with words.. chills and sweating, left ear pain .

Release 6 — day 21, dose 1

2021-03-29

Symptoms: Joint paint, bursitis in my elbow, redness & warmth around injection site, abdominal pain, fatigue, confusion or fogginess and forgetfulness..

Release 7 — day 7, dose 2

2021-04-10

Systemic reaction (other): EAR RINGING !! DRIVING ME INSANE!

Release 7 — day 14, dose 2

2021-04-13

Symptoms: Loud screeching noise in both ears

Release 8 — day 28, dose 2

2021-04-26

Symptoms: Severe high pitched ringing in both ears.. joint pain in elbows, wrist and knees! Noise won't stop! maddening

Release 8 — day 42, dose 2

2021-05-09

Symptoms: I want to kill myself.. I've gone crazy .. vaccine is shit

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Sore throat, hoarse voice, extensive bruising! Eccymosis?Fatigued!

Release 11 — 12 months, dose 2

2022-03-31

Symptoms: Ringing in the ears. Tinnitus! Its maddening..

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	Abdominal pain	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Bursitis	✓	✓	✓
SD	Confusional state	✓	✓	✓
SD	Contusion	✓	✓	✓
SD	Dysphonia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Suicidal ideation	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Aphasia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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