6DU-90265-85285

2 vaccinations 10 coded responses 15 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 981 / WA
Registered: 2021-03-11

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

2021-02-11
Dose 1 — Moderna
2021-03-11
Registered in v-safe
2021-03-11
Dose 2 — Moderna
2021-03-11
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Restlessness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Restlessness, inability to get comfortable, pain in the occipital region

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Ear pain, Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: intermittent left ear pain, sore throat and cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Ear pain, Insomnia, Joint stiffness, Musculoskeletal stiffness, Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work

Free text: stiff neck, shoulders and left jaw; pain around left ear; sore throat and cough; sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Ear pain, Musculoskeletal stiffness — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches

Free text: setup a stiff neck and shoulders, cough and left ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Musculoskeletal stiffness, Oropharyngeal pain, Secretion discharge — Feeling: Poor · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Stiffness is neck has increased as has sore throat, cough and mucus.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Survey response — day 28, dose 2
MedDRA: Cough, Dyspnoea, Hypersensitivity, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Allergic reaction resulted in croupy cough, congestion and difficulty breathing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-22
Survey response — day 42, dose 2
MedDRA: Cough, Medical counselling — 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: Symptoms: Coughing requiring steroids to get under control. · Healthcare visit (other): After hours consult and Rx

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-12
Survey response — 3 months, dose 2
MedDRA: Cough, Dermatitis allergic, Ear pain, Hypersensitivity, Insomnia, Paranasal sinus discomfort, Productive cough, Rhinorrhoea, Tinnitus — 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: Barking cough with lots of phlegm, sinus pressure, nasal discharge, ear pain and ringing, trouble sleeping, various allergic reactions presenting as bronchial, sinus or skin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Chills, Diarrhoea, Food poisoning, Hyperhidrosis, Pyrexia, SARS-CoV-2 test — Feeling: Poor · Be unable to work or attend school, 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: Diarrhea, chills, sweats, low grade intermittent fever since last Saturday night. Think it's food poisoning but had a COVID test today just in case.

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-14
Call 1 — Left Voicemail
2022-03-13
Survey response — 12 months, dose 2
MedDRA: Office visit, Surgery, Vaginal polyp — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Vaginal polyps · Healthcare visit (other): outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-12

Systemic reaction (other): Restlessness, inability to get comfortable, pain in the occipital region

2021-03-14

Systemic reaction (other): intermittent left ear pain, sore throat and cough

2021-03-15

Systemic reaction (other): stiff neck, shoulders and left jaw; pain around left ear; sore throat and cough; sleeplessness

2021-03-16

Systemic reaction (other): setup a stiff neck and shoulders, cough and left ear pain

2021-03-17

Systemic reaction (other): Stiffness is neck has increased as has sore throat, cough and mucus.

Release 7 — day 28, dose 2

2021-04-08

Symptoms: Allergic reaction resulted in croupy cough, congestion and difficulty breathing.

Release 7 — day 42, dose 2

2021-04-22

Symptoms: Coughing requiring steroids to get under control.

Healthcare visit (other): After hours consult and Rx

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: Barking cough with lots of phlegm, sinus pressure, nasal discharge, ear pain and ringing, trouble sleeping, various allergic reactions presenting as bronchial, sinus or skin.

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Diarrhea, chills, sweats, low grade intermittent fever since last Saturday night. Think it's food poisoning but had a COVID test today just in case.

Release 11 — 12 months, dose 2

2022-03-13

Symptoms: Vaginal polyps

Healthcare visit (other): outpatient surgery

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Surgery	·	·	✓
SD	Chills	·	·	✓
SD	Cough	✓	✓	✓
SD	Dermatitis allergic	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Food poisoning	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Vaginal polyp	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Joint stiffness	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Restlessness	✓	✓	✓
SRO	Secretion discharge	✓	✓	✓

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