6AR-18452-60556

4 vaccinations 13 coded responses 38 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 342 / FL
Registered: 2021-03-03

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

2021-03-02
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Tingling all over.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Good

Free text: I have experienced constipation since the vaccine. I have never had this problem prior to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Good

Free text: GI constipation. Started day after vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — day 14, dose 1
MedDRA: Migraine — Feeling: Fair

Free text: Migraine headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 21, dose 1
MedDRA: Headache, Migraine, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Migraine and what seems like an unstoppable headache. · Healthcare visit (other): Family Practice Office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Good · Nausea

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal dreams, Insomnia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Inability to sleep last night with fitful dreams.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-03
Survey response — 6 months, dose 2
MedDRA: Cataract, Otitis media — Feeling: Good

Free text: Cataracts right and left eye. Otitis media left ear. Resolved.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Dose 3 — Moderna
2022-01-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-02
Survey response — 12 months, dose 2
MedDRA: Synovial cyst — Feeling: Good

Free text: Bakers cyst left knee.

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Dose 4 — Moderna
2022-10-14
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-15
Survey response — days 1–6 daily, dose 4
MedDRA: Urticaria — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Hives on both arms the night following the injection.

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-18
Survey response — days 1–6 daily, dose 4
MedDRA: Throat irritation — Feeling: Good

Free text: Scratchy throat

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Survey response — days 1–6 daily, dose 4
MedDRA: Lymph node pain — Feeling: Good

Free text: Forgot to report two/three days ago had pain in lymph node under injection site

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Survey response — days 1–6 daily, dose 4
MedDRA: Lymph node pain — Feeling: Good

Free text: Lymph node sensitivity decreasing under injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-20
Survey response — day 35, dose 4
MedDRA: Vertigo — Feeling: Fair · Be unable to do your normal daily activities

Free text: Vertigo for 24 hours

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-16
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-04-01	Moderna
3	2021-11-18	Moderna	No
4	2022-10-14	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Tingling all over.

2021-03-07

Systemic reaction (other): I have experienced constipation since the vaccine. I have never had this problem prior to the vaccine.

2021-03-08

Systemic reaction (other): GI constipation. Started day after vaccine

Release 5 — day 14, dose 1

2021-03-16

Symptoms: Migraine headache

Release 6 — day 21, dose 1

2021-03-23

Symptoms: Migraine and what seems like an unstoppable headache.

Healthcare visit (other): Family Practice Office

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Inability to sleep last night with fitful dreams.

Release 9 — 6 months, dose 2

2021-10-03

Symptoms: Cataracts right and left eye. Otitis media left ear. Resolved.

Release 11 — 12 months, dose 2

2022-04-02

Symptoms: Bakers cyst left knee.

Release 12 — days 1–6 daily, dose 4

2022-10-15

Systemic reaction (other): Hives on both arms the night following the injection.

2022-10-18

Systemic reaction (other): Scratchy throat

2022-10-19

Systemic reaction (other): Forgot to report two/three days ago had pain in lymph node under injection site

2022-10-20

Systemic reaction (other): Lymph node sensitivity decreasing under injection site.

Release 12 — day 35, dose 4

2022-11-20

Symptoms: Vertigo for 24 hours

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	Cataract	·	·	✓
SD	Headache	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Otitis media	·	·	✓
SD	Synovial cyst	·	·	✓
SD	Vertigo	·	·	✓
SRO	Abnormal dreams	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Throat irritation	·	·	✓
SRO	Urticaria	·	·	✓

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