6BJ-31277-32221

5 vaccinations 36 coded responses 64 check-ins 31 free-text entries 4 call cases

Sex: —
Age at first dose: 51-55
ZIP prefix: 837 / ID
Registered: 2021-04-02

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-04-02
Registered in v-safe
2021-04-02
Dose 1 — Moderna
2021-04-02
Survey response — day 0, dose 1
MedDRA: Headache — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Headache was before shot

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

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling

Free text: Blood sugars are ok.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased — Feeling: Fair · Fatigue or tiredness

Free text: Blood sugars r high

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-09
Survey response — day 7, dose 1
MedDRA: Depression — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Just depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 14, dose 1
MedDRA: Blood glucose increased — Feeling: Fair

Free text: High blood sugars continue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-30
Dose 2 — Moderna
2021-04-30
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Abdominal pain

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches

Free text: Will watch blood sugars as they ran high after 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Muscle or body aches

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth, Pollakiuria — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Since 1st shot, have overnight dry mouth & overnight increased trips to bathroom

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth, Nocturia — Feeling: Fair · Fatigue or tiredness

Free text: Overnight dry mouth & overnight increased trips to bathroom

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-14
Survey response — day 14, dose 2
MedDRA: Epistaxis — Feeling: Good

Free text: Forgot to add that 4 or 5 days after 2nd shot, I had 1 moderate bloody nose. Came out of nowhere. Only the 1 time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 21, dose 2
MedDRA: Hypoaesthesia — Feeling: Poor · 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: Dentol problem, numb left side of face for 3 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-28
Survey response — day 28, dose 2
MedDRA: Bell's palsy, Dry eye, Mastication disorder, Office visit — Feeling: Fair · 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: Went to urgent care twice, on 2nd visit i got meds for possible Bells Paulsy. Been difficult with chewing & dry eye.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — day 28, dose 2
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)
2021-06-04
Survey response — day 35, dose 2
MedDRA: Bell's palsy, Neuralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Recovering from possible Bells Palsy, nerve is letting me know its waking up with small pain jolts. Blah blah

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 42, dose 2
MedDRA: Bell's palsy, Headache, Muscle spasms, Neck pain, Pain in jaw — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still recovering from possible Bells Palsy. Get face cramps & soreness on left side of head & neck & jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-01
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Survey response — 6 months, dose 2
MedDRA: Bell's palsy, Ear discomfort — Feeling: Fair

Free text: Some moments of ear pressure, few seconds than all is normal. Still recovering from bells palsy.

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Dose 3 — Moderna
2021-12-19
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: I'm watching blood sugars since I also have type 1 diabetes

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-22
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache

Free text: HÃ ve Type 1 diabetes

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Right side neck & shoulder pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Survey response — days 1–6 daily, dose 3
MedDRA: Neck pain — Feeling: Good · Abdominal pain

Free text: Right side neck pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2022-01-01
Survey response — day 14, dose 3
MedDRA: Gastrointestinal disorder — Feeling: Good

Free text: Tummy troubles

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — day 21, dose 3
MedDRA: Blood glucose increased, Gastrointestinal disorder, Heart rate increased — Feeling: Fair

Free text: Extremely high blood sugars, tummy troubles, rapid heart rate.

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Survey response — day 28, dose 3
MedDRA: Blood glucose increased — Feeling: Good

Free text: Continued very high blood sugars

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Survey response — day 35, dose 3
MedDRA: Blood glucose fluctuation, Pre-existing disease — Feeling: Good · 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: Switched from multiple daily injections to an insulin pump. There's some trial & error high/low blood sugars.

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-01-29
Survey response — day 42, dose 3
MedDRA: Gastrointestinal disorder — Feeling: Fair

Free text: Tummy troubles

MedDRA releases: 2024-11 · check-in free text available
2022-03-19
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-10
Dose 4 — Moderna
2022-06-11
Survey response — days 1–6 daily, dose 4
MedDRA: Blood glucose decreased — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Low blood sugars today

MedDRA releases: 2024-11 · check-in free text available
2022-06-12
Survey response — days 1–6 daily, dose 4
MedDRA: Initial insomnia, Middle insomnia — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Trouble falling & staying asleep during night

MedDRA releases: 2024-11 · check-in free text available
2022-06-13
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site erythema, Pre-existing disease — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Redness is 2 spots on right side of injection site. Watching blood sugars, type 1 diabetic

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness · Rash, not including the immediate area around the injection site

Adult check-in
2022-06-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-06-16
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Redness · Chills, Muscle or body aches, Fatigue or tiredness

Free text: May be thyroid deficiency, on diff dosage

MedDRA releases: 2024-11 · check-in free text available
2022-06-17
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-06-24
Survey response — day 14, dose 4
MedDRA: Pain in extremity, Paraesthesia — Feeling: Good · Be unable to do your normal daily activities

Free text: Increased tingling & pain in hands

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Survey response — day 21, dose 4
MedDRA: Paraesthesia — Feeling: Good · Be unable to do your normal daily activities

Free text: Worse hand tingling- may be carpal tunnel

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Survey response — day 28, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increased finger tingling & foot cramps. Have had these in the past, B4 covid.

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Survey response — day 35, dose 4
MedDRA: Muscle spasms, Onychoclasis — Feeling: Good

Free text: Muscle cramps & brittle fingernails

MedDRA releases: 2024-11 · check-in free text available
2022-07-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-10
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-03-03
Dose 5 — Moderna
2023-03-04
Survey response — days 1–6 daily, dose 5
MedDRA: Chills, Self-medication — Feeling: Poor · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-05
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2023-03-06
Survey response — days 1–6 daily, dose 5
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11
2023-03-07
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches, Abdominal pain

Adult check-in
2023-03-08
Survey response — days 1–6 daily, dose 5
MedDRA: Type 1 diabetes mellitus — Feeling: Fair · Headache, Muscle or body aches, Diarrhea

MedDRA releases: 2024-11
2023-03-09
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2023-03-10
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2023-03-17
Survey response — day 14, dose 5
MedDRA: Carpal tunnel syndrome, Dupuytren's contracture, Muscle tightness — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-17
Report sent to call center — day 14, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-20
Call 1 — Left Voicemail
2023-03-20
Call 1 — Left Voicemail
2023-03-20
Call 2 — Left Voicemail
2023-03-20
Call 1 — Left Voicemail
2023-03-24
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-03-31
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2023-04-07
Survey response — day 35, dose 5
MedDRA: Nasal dryness — Feeling: Good

MedDRA releases: 2024-11
2023-04-17
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-06-02
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-02	Moderna
2	2021-04-30	Moderna
3	2021-12-18	Moderna	No
4	2022-06-10	Moderna	No
5	2023-03-03	Moderna	No

Call center

4 call center cases

4 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-04-02

Systemic reaction (other): Headache was before shot

Release 6 — days 1–6 daily, dose 1

2021-04-04

Systemic reaction (other): Blood sugars are ok.

2021-04-05

Systemic reaction (other): Blood sugars r high

Release 7 — day 7, dose 1

2021-04-09

Systemic reaction (other): Just depression

Release 7 — day 14, dose 1

2021-04-16

Symptoms: High blood sugars continue

Release 8 — days 1–6 daily, dose 2

2021-05-01

Systemic reaction (other): Will watch blood sugars as they ran high after 1st shot

2021-05-05

Systemic reaction (other): Since 1st shot, have overnight dry mouth & overnight increased trips to bathroom

2021-05-06

Systemic reaction (other): Overnight dry mouth & overnight increased trips to bathroom

Release 8 — day 14, dose 2

2021-05-14

Symptoms: Forgot to add that 4 or 5 days after 2nd shot, I had 1 moderate bloody nose. Came out of nowhere. Only the 1 time.

Release 8 — day 21, dose 2

2021-05-21

Symptoms: Dentol problem, numb left side of face for 3 days

Release 8 — day 28, dose 2

2021-05-28

Symptoms: Went to urgent care twice, on 2nd visit i got meds for possible Bells Paulsy. Been difficult with chewing & dry eye.

Release 8 — day 35, dose 2

2021-06-04

Symptoms: Recovering from possible Bells Palsy, nerve is letting me know its waking up with small pain jolts. Blah blah

Release 9 — day 42, dose 2

2021-06-11

Symptoms: Still recovering from possible Bells Palsy. Get face cramps & soreness on left side of head & neck & jaw.

Release 10 — 6 months, dose 2

2021-10-29

Symptoms: Some moments of ear pressure, few seconds than all is normal. Still recovering from bells palsy.

Release 10 — days 1–6 daily, dose 3

2021-12-19

Systemic reaction (other): I'm watching blood sugars since I also have type 1 diabetes

2021-12-22

Systemic reaction (other): HÃ ve Type 1 diabetes

2021-12-23

Systemic reaction (other): Right side neck & shoulder pain

2021-12-24

Systemic reaction (other): Right side neck pain

Release 10 — day 14, dose 3

2022-01-01

Symptoms: Tummy troubles

Release 10 — day 21, dose 3

2022-01-08

Symptoms: Extremely high blood sugars, tummy troubles, rapid heart rate.

Release 10 — day 28, dose 3

2022-01-15

Symptoms: Continued very high blood sugars

Release 11 — day 35, dose 3

2022-01-22

Symptoms: Switched from multiple daily injections to an insulin pump. There's some trial & error high/low blood sugars.

Release 11 — day 42, dose 3

2022-01-29

Symptoms: Tummy troubles

Release 12 — days 1–6 daily, dose 4

2022-06-11

Systemic reaction (other): Low blood sugars today

2022-06-12

Systemic reaction (other): Trouble falling & staying asleep during night

2022-06-13

Systemic reaction (other): Redness is 2 spots on right side of injection site. Watching blood sugars, type 1 diabetic

2022-06-16

Systemic reaction (other): May be thyroid deficiency, on diff dosage

Release 12 — day 14, dose 4

2022-06-24

Symptoms: Increased tingling & pain in hands

Release 12 — day 21, dose 4

2022-07-01

Symptoms: Worse hand tingling- may be carpal tunnel

Release 12 — day 28, dose 4

2022-07-08

Symptoms: Increased finger tingling & foot cramps. Have had these in the past, B4 covid.

Release 12 — day 35, dose 4

2022-07-15

Symptoms: Muscle cramps & brittle fingernails

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	Bell's palsy	✓	✓	✓
SD	Blood glucose fluctuation	·	·	✓
SD	Blood glucose increased	✓	✓	✓
SD	Carpal tunnel syndrome	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Dry eye	✓	✓	✓
SD	Dupuytren's contracture	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Epistaxis	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	·	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Mastication disorder	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Muscle tightness	·	·	✓
SD	Nasal dryness	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Onychoclasis	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pain in jaw	✓	✓	✓
SD	Paraesthesia	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Blood glucose decreased	·	·	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Depression	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Initial insomnia	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Middle insomnia	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Nocturia	✓	✓	✓
SRO	Pollakiuria	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Type 1 diabetes mellitus	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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