63D-26192-35692

2 vaccinations 12 coded responses 15 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 921 / CA
Registered: 2021-01-09

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-02
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Survey response — day 7, dose 1
MedDRA: Acne, Back pain, Chest pain, Furuncle, Headache, Pain, Thrombosis — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, 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: Acne / boils around my facial hairline. Blot clot/radiating pain in my chest, back, & head.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-16
Survey response — day 14, dose 1
MedDRA: Chills, Dizziness, Eye pain, Headache, Lethargy, Medical counselling, Muscle spasms, Self-medication — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: The worst frontal lobe headache ever. Aspirin is helping. Still having chills. Now having some dizzy spells and pain behind my eyes. Very lethargic and lots of cramping in my pelvis, neck, legs and back. · Healthcare visit (other): Messaged my PCP MD.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-25
Survey response — day 21, dose 1
MedDRA: Chest pain, Chills, Fatigue, Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, low grade fever, chills, headache, pain in chest, sore throat, sneezing, runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Dose 2 — Moderna
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Emergency care, Feeling hot, Hypersensitivity, Oral pruritus, Throat irritation — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Abdominal pain · 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: I had an allergic reaction to the vaccine. Itchy throat & mouth, and warmness through my head & neck. Went to ER to get reaction to calm down.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenopia, Nasopharyngitis — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Super tired eyes and cold like symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Flatulence — Feeling: Fair · Site: Pain, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Lots of gas & lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Lip blister — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very blistering lips & shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Call 1 — Left Voicemail
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Survey response — day 28, dose 2
MedDRA: Chills, Eye pain, Eye swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Left Eye is swelling up and giving me pain where I had a laser barricade surgery last year. Chills.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 35, dose 2
MedDRA: Angina pectoris, Chest discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart pain & tightness in my chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Hypoaesthesia — Feeling: Good · Be unable to do your normal daily activities

Free text: Heart & chest tightness and numbing sensations in lungs and neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-11
Call 1 — Left Voicemail
2021-08-02
Survey response — 6 months, dose 2
MedDRA: Head discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pressure in my left frontal lobe area of my head.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-30
Survey response — 12 months, dose 2
MedDRA: Dyspnoea, Headache, Pulmonary pain, Sensory disturbance — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lots of sensation in my brain frontal lobe. Headaches and also shortness of breath and lung pain.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-01-30	Moderna

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 7, dose 1

2021-01-09

Systemic reaction (other): Acne / boils around my facial hairline. Blot clot/radiating pain in my chest, back, & head.

Release 2 — day 14, dose 1

2021-01-16

Symptoms: The worst frontal lobe headache ever. Aspirin is helping. Still having chills. Now having some dizzy spells and pain behind my eyes. Very lethargic and lots of cramping in my pelvis, neck, legs and back.

Healthcare visit (other): Messaged my PCP MD.

Release 2 — day 21, dose 1

2021-01-25

Symptoms: Fatigue, low grade fever, chills, headache, pain in chest, sore throat, sneezing, runny nose

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): I had an allergic reaction to the vaccine. Itchy throat & mouth, and warmness through my head & neck. Went to ER to get reaction to calm down.

2021-02-03

Systemic reaction (other): Super tired eyes and cold like symptoms

2021-02-05

Systemic reaction (other): Lots of gas & lower back pain

Release 4 — day 14, dose 2

2021-02-13

Symptoms: Very blistering lips & shortness of breath.

Release 4 — day 28, dose 2

2021-03-01

Symptoms: Left Eye is swelling up and giving me pain where I had a laser barricade surgery last year. Chills.

Release 5 — day 35, dose 2

2021-03-11

Symptoms: Heart pain & tightness in my chest

Release 5 — day 42, dose 2

2021-03-15

Symptoms: Heart & chest tightness and numbing sensations in lungs and neck.

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: Pressure in my left frontal lobe area of my head.

Release 11 — 12 months, dose 2

2022-01-30

Symptoms: Lots of sensation in my brain frontal lobe. Headaches and also shortness of breath and lung pain.

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	Angina pectoris	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Eye swelling	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	✓	·	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Lip blister	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pulmonary pain	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sensory disturbance	·	·	✓
SD	Sneezing	✓	✓	✓
SRO	Acne	✓	✓	✓
SRO	Asthenopia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Furuncle	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Oral pruritus	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Thrombosis	✓	✓	✓

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