5VD-16979-29263

3 vaccinations 15 coded responses 39 check-ins 15 free-text entries 5 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 479 / IN
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Paranasal sinus hypersecretion — Feeling: Good · Site: Pain · Joint pains

Free text: Sinus drainage and cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Rhinorrhoea, Sinusitis — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Slight sinus runny nose causing drainage and cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pain, Paranasal sinus hypersecretion — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eye ball pain. Pain in eyes when looking up or down. Lots of clear sinus drainage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Eye pain, Headache, Sinus congestion — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: A lot of sinus congestion and left eyeball pain. 1 Tylenol helped with joint pain and head pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Burning sensation, Decreased appetite, Eye pain, Paranasal sinus hypersecretion, Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Burning sensation in upper sinuses. Congestion and sinus drainage.Slight left eye ball pain. Decreased appetite.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-13
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-25
Dose 2 — Moderna
2021-01-25
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Headache

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Anger — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Nausea

Free text: Angry mood

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Joint pains

Free text: Better Mood today!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Affective disorder — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Bad and poor mood

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Mood altered — Feeling: Fair · Headache, Joint pains, Muscle or body aches

Free text: Bad Mood

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — day 7, dose 2
MedDRA: Depressed mood — Feeling: Fair · Joint pains

Free text: Poor mood

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-15
Survey response — day 21, dose 2
MedDRA: Nausea — Feeling: Fair

Free text: Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 28, dose 2
MedDRA: Headache, Neck pain — Feeling: Fair

Free text: Neck ache and headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-08
Survey response — day 42, dose 2
MedDRA: Abdominal distension, Nausea — Feeling: Good

Free text: Nausea and bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-26
Survey response — 6 months, dose 2
MedDRA: Throat irritation — Feeling: Fair

Free text: Scratchy throat

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-30
Dose 3 — Moderna
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Nausea

Adult check-in
2021-11-06
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-11-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-30
Survey response — 6 months, dose 3
MedDRA: Dizziness, Pre-existing disease — Feeling: Fair

Free text: Dizziness and allergies

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-25	Moderna
3	2021-10-30	Moderna	No

Call center

5 call center cases

5 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Sinus drainage and cough

2021-01-02

Systemic reaction (other): Slight sinus runny nose causing drainage and cough

2021-01-03

Systemic reaction (other): Eye ball pain. Pain in eyes when looking up or down. Lots of clear sinus drainage

2021-01-04

Systemic reaction (other): A lot of sinus congestion and left eyeball pain. 1 Tylenol helped with joint pain and head pain.

2021-01-05

Systemic reaction (other): Burning sensation in upper sinuses. Congestion and sinus drainage.Slight left eye ball pain. Decreased appetite.

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Angry mood

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Better Mood today!

2021-01-30

Systemic reaction (other): Bad and poor mood

2021-01-31

Systemic reaction (other): Bad Mood

Release 3 — day 7, dose 2

2021-02-01

Systemic reaction (other): Poor mood

Release 4 — day 21, dose 2

2021-02-15

Symptoms: Nausea

Release 4 — day 28, dose 2

2021-02-22

Symptoms: Neck ache and headache

Release 5 — day 42, dose 2

2021-03-08

Symptoms: Nausea and bloating

Release 9 — 6 months, dose 2

2021-07-26

Symptoms: Scratchy throat

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: Dizziness and allergies

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 distension	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Headache	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Throat irritation	✓	·	✓
SRO	Affective disorder	✓	✓	✓
SRO	Anger	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Depressed mood	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Mood altered	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sinus operation	○	○	○
SRO	Sinusitis	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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