67U-28288-59137

3 vaccinations 15 coded responses 41 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 435 / OH
Registered: 2021-01-06

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain

Free text: Lightheaded when first woke up for brief time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Migraine, Visual impairment — Feeling: Good · Be unable to do your normal daily activities

Free text: Migraine last evening with visual disturbances (have had occasionally in the past)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-27
Survey response — day 21, dose 1
MedDRA: Migraine, Visual impairment — Feeling: Good · Be unable to do your normal daily activities

Free text: Have had 6 migraines with visual disturbances. History of in the past but typically only once or twice a year. Visual aspect clears typically in half hour.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Dose 2 — Moderna
2021-02-03
Survey response — day 0, dose 2
MedDRA: Flushing, Immediate post-injection reaction, Pain in extremity — Feeling: Fair · Site: Pain · Muscle or body aches, Abdominal pain

Free text: Felt flushed off and on. For the second dose, my arm started hurting in less than 5 minutes. First one was hours later.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Transient weakness. Would have needed to call off work but am working remotely so did not.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Good · Site: Pain

Free text: Transient weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Survey response — day 21, dose 2
MedDRA: Blood pressure increased, Heart rate increased, Hypertension, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: Resting heart rate sometimes increasing in the 110s and 120s. Happened a couple times after the first dose but has increased in frequency following the second dose. A few times BP has also increased (150s over 111) but then comes down.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Blood pressure increased, Tinnitus — Feeling: Fair

Free text: Occasional ringing in ears at times. BP is up at times.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-16
Dose 3 — Moderna
2021-12-16
Survey response — day 0, dose 3
MedDRA: Tinnitus, Vision blurred — Feeling: Good · Headache

Free text: Blurred vision for short time and later buzzing in ears for short time

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Had ear buzzing for awhile.

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-20
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Occasional buzzing/ringing in ears.

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling cold — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Not really chills but just feel cold off and on

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-23
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-08
Survey response — day 21, dose 3
MedDRA: Abdominal pain upper, Respiratory tract congestion — Feeling: Fair

Free text: Congestion and stomach pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-16
Survey response — 6 months, dose 3
MedDRA: Abdominal pain lower, Office visit, Stool DNA test positive — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Lower left abdominal pain-CT ordered for possible diverticulitis: positive cologuard test, mammogram asymmetry with follow up films ordered, heart rate sometimes in 110-120 range · Healthcare visit (other): Clinic visits

MedDRA releases: 2024-11 · check-in free text available
2022-06-16
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-17
Call 1 — Left Voicemail
2022-12-16
Survey response — 12 months, dose 3
MedDRA: Barrett's oesophagus — Feeling: Fair · Be unable to work or attend school

Free text: Diagnosed with Barrett's esophagus (only missed work for testing)

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna
3	2021-12-16	Moderna	No

Call center

2 call center cases

1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Lightheaded when first woke up for brief time

2021-01-12

Systemic reaction (other): Migraine last evening with visual disturbances (have had occasionally in the past)

Release 2 — day 21, dose 1

2021-01-27

Symptoms: Have had 6 migraines with visual disturbances. History of in the past but typically only once or twice a year. Visual aspect clears typically in half hour.

Release 3 — day 0, dose 2

2021-02-03

Systemic reaction (other): Felt flushed off and on. For the second dose, my arm started hurting in less than 5 minutes. First one was hours later.

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Transient weakness. Would have needed to call off work but am working remotely so did not.

2021-02-06

Systemic reaction (other): Transient weakness

Release 4 — day 21, dose 2

2021-02-24

Symptoms: Resting heart rate sometimes increasing in the 110s and 120s. Happened a couple times after the first dose but has increased in frequency following the second dose. A few times BP has also increased (150s over 111) but then comes down.

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Occasional ringing in ears at times. BP is up at times.

Release 10 — day 0, dose 3

2021-12-16

Systemic reaction (other): Blurred vision for short time and later buzzing in ears for short time

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Had ear buzzing for awhile.

2021-12-20

Systemic reaction (other): Occasional buzzing/ringing in ears.

2021-12-21

Systemic reaction (other): Not really chills but just feel cold off and on

Release 10 — day 21, dose 3

2022-01-08

Symptoms: Congestion and stomach pain

Release 12 — 6 months, dose 3

2022-06-16

Symptoms: Lower left abdominal pain-CT ordered for possible diverticulitis: positive cologuard test, mammogram asymmetry with follow up films ordered, heart rate sometimes in 110-120 range

Healthcare visit (other): Clinic visits

Release 12 — 12 months, dose 3

2022-12-16

Symptoms: Diagnosed with Barrett's esophagus (only missed work for testing)

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	Office visit	·	·	✓
SD	Abdominal pain lower	·	·	✓
SD	Abdominal pain upper	·	·	✓
SD	Barrett's oesophagus	·	·	✓
SD	Blood pressure increased	✓	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypertension	○	✓	○
SD	Migraine	✓	✓	✓
SD	Reaction to previous exposure to any vaccine	✓	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Stool DNA test positive	·	·	✓
SD	Tinnitus	✓	·	✓
SD	Visual impairment	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling cold	·	·	✓
SRO	Flushing	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Tinnitus	·	·	✓
SRO	Vision blurred	·	·	✓
SRO	Visual impairment	✓	✓	✓

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