6CM-15850-98826

4 vaccinations 6 coded responses 33 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 781 / TX
Registered: 2021-03-07

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

2021-02-04
Dose 1 — Moderna
2021-03-04
Dose 2 — Moderna
2021-03-07
Registered in v-safe
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: All of these on the two days following the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-11
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Good · Fatigue or tiredness

Free text: It may not be related but increase in tinnitus.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 21, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Im not certain its due to the vaccination but my tinnitus is really bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — day 42, dose 2
MedDRA: Myalgia, Tinnitus, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have had muscle ache in the shoulder where I received both my first and second injection. I am beginning to think k it might be related.My tinnitus had been severe and I am wondering if there is any correlation to the vaccine. · Healthcare visit (other): I have an ENT appointment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fever · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-25
Survey response — 6 months, dose 3
MedDRA: Bronchitis, Influenza — Feeling: Fair · Be unable to do your normal daily activities

Free text: Flu Type A Bronchitis

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Call 1 — Left Voicemail
2022-05-14
Dose 4 — Moderna
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Itching · Fever · Chills, Headache, Muscle or body aches

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Itching · Fever · Headache

Adult check-in
2022-05-21
Survey response — day 7, dose 4
MedDRA: Fatigue — Feeling: Fair · Site: Redness, Itching · Fever

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-05-15
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-10-25	Moderna	No
4	2022-05-14	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): All of these on the two days following the injection

Release 5 — day 7, dose 2

2021-03-11

Systemic reaction (other): It may not be related but increase in tinnitus.

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Im not certain its due to the vaccination but my tinnitus is really bad.

Release 7 — day 42, dose 2

2021-04-20

Symptoms: I have had muscle ache in the shoulder where I received both my first and second injection. I am beginning to think k it might be related.My tinnitus had been severe and I am wondering if there is any correlation to the vaccine.

Healthcare visit (other): I have an ENT appointment.

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: Flu Type A Bronchitis

Release 11 — day 7, dose 4

2022-05-21

Systemic reaction (other): Fatigue

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	Unevaluable event	✓	✓	✓
SD	Bronchitis	·	·	✓
SD	Influenza	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Tinnitus	✓	✓	✓

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