6RL-33702-86112

2 vaccinations 9 coded responses 17 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 752 / TX
Registered: 2021-04-30

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

2021-04-13
Dose 1 — Moderna
2021-04-30
Registered in v-safe
2021-04-30
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-10
Dose 2 — Moderna
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Crying, Irritability — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Irritability and easily crying

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Muscle tightness, Pain, Pain in jaw — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: My jaw is very tight and there is some pain/achy-ness when I try to open it to put food in (Im not trying to open it widejust functional!), and restriction. Chewing causes jaw fatigue quickly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dyskinesia, Fatigue, Jaw disorder, Mastication disorder, Muscle tightness, Pain in jaw, Yawning — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Jaw symptoms are still somewhat severe. The pain is fairly mild at rest, but cant open my mouth wide enough to eat normally and yawning is painful! Chewing is exhausting because of the tightness and restriction in my jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Muscle tightness, Pain in jaw — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Still have a really tight jaw with soreness. Quick to fatigue when eating.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — day 7, dose 2
MedDRA: Mastication disorder, Muscle tightness, Pain, Pain in jaw — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Jaw still really tight & achy with restriction. Yawning still hurts, opening my mouth wide enough to eat is difficult, chewing is exhausting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-31
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-09
Survey response — day 28, dose 2
MedDRA: Asthma, Eye pruritus, Headache, Inflammation, Nasal pruritus, Oropharyngeal pain, Pre-existing disease, Pruritus, Rash, Sinus congestion — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Splitting headache, sinus congestion, itchy eyes, nose, & ears, sore throat, rash on face, scalp, and chest; inflamed airways, asthma symptoms worsening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Survey response — day 35, dose 2
MedDRA: Eczema, Eye irritation, Nasal congestion, Pruritus, Rash — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Eczema, itchiness, rash, eye irritation, and ongoing stuffiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-10
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Diarrhoea, Eczema — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diarrhea, joint pain, eczema

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-08
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-05-10
Survey response — 12 months, dose 2
MedDRA: Asthma, Cough, Office visit, Pre-existing disease, Respiratory tract congestion, Sneezing — 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

Free text: Symptoms: Currently severe asthma flare + cough, sneezing & stuffy head (no fever or body aches) · Healthcare visit (other): Saw my Allergy & Asthma Doctor's PA in person for a nasal swab to test for most common viruses and bacterial respiratory infections

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
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

1 call case(s)
2022-05-11
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Moderna
2	2021-05-10	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): Irritability and easily crying

2021-05-13

Systemic reaction (other): My jaw is very tight and there is some pain/achy-ness when I try to open it to put food in (Im not trying to open it widejust functional!), and restriction. Chewing causes jaw fatigue quickly.

2021-05-14

Systemic reaction (other): Jaw symptoms are still somewhat severe. The pain is fairly mild at rest, but cant open my mouth wide enough to eat normally and yawning is painful! Chewing is exhausting because of the tightness and restriction in my jaw.

2021-05-16

Systemic reaction (other): Still have a really tight jaw with soreness. Quick to fatigue when eating.

Release 8 — day 7, dose 2

2021-05-17

Systemic reaction (other): Jaw still really tight & achy with restriction. Yawning still hurts, opening my mouth wide enough to eat is difficult, chewing is exhausting.

Release 8 — day 28, dose 2

2021-06-09

Symptoms: Splitting headache, sinus congestion, itchy eyes, nose, & ears, sore throat, rash on face, scalp, and chest; inflamed airways, asthma symptoms worsening

Release 9 — day 35, dose 2

2021-06-14

Symptoms: Eczema, itchiness, rash, eye irritation, and ongoing stuffiness

Release 9 — 3 months, dose 2

2021-08-10

Symptoms: Diarrhea, joint pain, eczema

Release 11 — 12 months, dose 2

2022-05-10

Symptoms: Currently severe asthma flare + cough, sneezing & stuffy head (no fever or body aches)

Healthcare visit (other): Saw my Allergy & Asthma Doctor's PA in person for a nasal swab to test for most common viruses and bacterial respiratory infections

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	Arthralgia	✓	·	✓
SD	Asthma	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	·	✓
SD	Eczema	✓	✓	✓
SD	Eye irritation	✓	✓	✓
SD	Eye pruritus	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasal pruritus	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinus congestion	✓	✓	✓
SD	Sneezing	·	·	✓
SRO	Crying	✓	✓	✓
SRO	Dyskinesia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Jaw disorder	✓	✓	✓
SRO	Mastication disorder	✓	✓	✓
SRO	Muscle tightness	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Yawning	✓	✓	✓

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