6CT-20729-00166

5 vaccinations 12 coded responses 58 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 349 / FL
Registered: 2021-02-18

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-18
Registered in v-safe
2021-02-18
Dose 1 — Moderna
2021-02-18
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-18
Dose 2 — Moderna
2021-03-18
Health check-in — day 0, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Dizziness, general itchiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Intermittent dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-25
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Intermittent dizzily

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Survey response — day 7, dose 3
MedDRA: Back pain, Chills, Head discomfort, Myalgia, Paranasal sinus discomfort — Feeling: Good

Free text: I had the booster a whole week ago. By 8 hours later I had lower back pain muscle aches and chills but no fever. My head felt really heavy and I had sinus pressure All lasted until the following night

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-30
Dose 4 — Moderna
2022-03-30
Survey response — day 0, dose 4
MedDRA: Tinnitus — Feeling: Good · Site: Pain

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Survey response — days 1–6 daily, dose 4
MedDRA: Back pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Lower back pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Survey response — days 1–6 daily, dose 4
MedDRA: Renal pain — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Kidney pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-02
Survey response — days 1–6 daily, dose 4
MedDRA: Renal pain, Tinnitus — Feeling: Fair · Site: Pain, Redness, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still have kidney pain and still have tinnitus (since a few hours after vaccine).

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Survey response — days 1–6 daily, dose 4
MedDRA: Renal pain, Tinnitus — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Kidneys still hurt, still have tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Survey response — days 1–6 daily, dose 4
MedDRA: Renal pain, Tinnitus — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Still mild kidney pain, still have tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-04-06
Survey response — day 7, dose 4
MedDRA: Tinnitus — Feeling: Good · Fatigue or tiredness

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-27
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-04
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-11
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-07
Dose 5 — Pfizer-BioNTech
2022-09-08
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good · Site: Pain, Itching

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-09-09
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Itching · Muscle or body aches

Adult check-in
2022-09-10
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-16
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-09-21
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-09-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-05
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-12
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-07
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-08
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-18	Moderna
2	2021-03-18	Moderna
3	2021-10-22	Moderna	No
4	2022-03-30	Moderna	No
5	2022-09-07	Pfizer-BioNTech	No

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Dizziness, general itchiness

2021-03-23

Systemic reaction (other): Intermittent dizziness

Release 6 — day 7, dose 2

2021-03-25

Systemic reaction (other): Intermittent dizzily

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): I had the booster a whole week ago. By 8 hours later I had lower back pain muscle aches and chills but no fever. My head felt really heavy and I had sinus pressure All lasted until the following night

Release 11 — day 0, dose 4

2022-03-30

Systemic reaction (other): Tinnitus

Release 11 — days 1–6 daily, dose 4

2022-03-31

Systemic reaction (other): Lower back pain

2022-04-01

Systemic reaction (other): Kidney pain

2022-04-02

Systemic reaction (other): Still have kidney pain and still have tinnitus (since a few hours after vaccine).

2022-04-03

Systemic reaction (other): Kidneys still hurt, still have tinnitus

2022-04-04

Systemic reaction (other): Still mild kidney pain, still have tinnitus

Release 11 — day 7, dose 4

2022-04-06

Systemic reaction (other): Tinnitus

Release 12 — days 1–6 daily, dose 5

2022-09-08

Systemic reaction (other): No

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
SRO	Back pain	·	·	✓
SRO	Chills	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Head discomfort	·	·	✓
SRO	Myalgia	·	·	✓
SRO	No adverse event	·	·	✓
SRO	Paranasal sinus discomfort	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Renal pain	·	·	✓
SRO	Tinnitus	·	·	✓

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