6M2-29396-52177

5 vaccinations 5 coded responses 69 check-ins 5 free-text entries 1 call case

Sex: —
Age at first dose: 51-55
ZIP prefix: 960 / CA
Registered: 2021-01-26

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Timeline

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Systemic lupus erythematosus — Feeling: Good · Fatigue or tiredness

Free text: This 1st shot gave me a lupus flare.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-20
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Dose 3 — Moderna
2021-08-20
Survey response — day 0, dose 3
MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling

Free text: No

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-08-22
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-08-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-08-27
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-09-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-10
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-09-17
Survey response — day 28, dose 3
MedDRA: Ear inflammation, Ear pain, Headache, Office visit — Feeling: Fair · Be unable to do your normal daily activities

Free text: Both Ears hurt still , have a slight headache still. Went to dr got nasal steroid for ear tuned inflammation but dont seem to be helping .

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Survey response — day 35, dose 3
MedDRA: Ear discomfort, Head discomfort, Headache, Migraine, Ocular discomfort, Office visit, Pain in jaw — Feeling: Fair · 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: Symptoms: Day before booster moderna I was totally fine, the night of vaccine I got massive migraine that I still have but its moderate headache since. Pressure in the head and ears and jaws and eye so oes has let up after 3day after shot but still have it! · Healthcare visit (other): I would go to the er but its full of Covid idiots. Saw a dr but he was no help!

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-09-29
Call 1 — Left Voicemail
2021-10-01
Survey response — day 42, dose 3
MedDRA: Ear pain, Head discomfort, Headache, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still my ears, ear pain and goes down side of neck , pressure feeling in my head and constant headache

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-18
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-07
Dose 4 — Moderna
2022-04-07
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-04-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-04-14
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-04-21
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-07
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-06
Dose 5 — Moderna
2022-10-06
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Joint pains

Adult check-in
2022-10-12
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2022-10-13
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-20
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-03
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-10
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-17
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-05
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-06
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-20	Moderna
3	2021-08-20	Moderna	No
4	2022-04-07	Moderna	No
5	2022-10-06	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): This 1st shot gave me a lupus flare.

Release 9 — day 0, dose 3

2021-08-20

Systemic reaction (other): No

Release 9 — day 28, dose 3

2021-09-17

Symptoms: Both Ears hurt still , have a slight headache still. Went to dr got nasal steroid for ear tuned inflammation but dont seem to be helping .

Release 9 — day 35, dose 3

2021-09-24

Symptoms: Day before booster moderna I was totally fine, the night of vaccine I got massive migraine that I still have but its moderate headache since. Pressure in the head and ears and jaws and eye so oes has let up after 3day after shot but still have it!

Healthcare visit (other): I would go to the er but its full of Covid idiots. Saw a dr but he was no help!

Release 9 — day 42, dose 3

2021-10-01

Symptoms: Still my ears, ear pain and goes down side of neck , pressure feeling in my head and constant headache

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	Ear discomfort	·	·	✓
SD	Ear inflammation	·	·	✓
SD	Ear pain	·	·	✓
SD	Head discomfort	·	·	✓
SD	Headache	·	·	✓
SD	Migraine	·	·	✓
SD	Neck pain	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Office visit	·	·	✓
SD	Pain in jaw	·	·	✓
SRO	No adverse event	✓	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Systemic lupus erythematosus	✓	✓	✓

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