6T9-28435-80580

2 vaccinations 9 coded responses 24 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 441 / OH
Registered: 2021-04-13

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

2021-04-12
Dose 1 — Moderna
2021-04-13
Registered in v-safe
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Chills, Fatigue or tiredness

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain

Free text: Both of arms are itching at my elbows. They are both red (because of scratching)but, no rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Fair · Site: Pain, Itching · Rash, not including the immediate area around the injection site

Free text: Rash on both arms on and around elbows.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Only on the left arm by the elbow. The right arm rash is gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-26
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-10
Dose 2 — Moderna
2021-05-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-31
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-21
Survey response — day 42, dose 2
MedDRA: Sinusitis — Feeling: Fair · 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: I have a sinus infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-21
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)
2021-06-29
Call 2 — Left Voicemail
2021-08-09
Survey response — 3 months, dose 2
MedDRA: Sinusitis — 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: Sinus infection.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-09
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)
2021-08-18
Call 2 — Left Voicemail
2021-11-08
Survey response — 6 months, dose 2
MedDRA: Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Survey response — 12 months, dose 2
MedDRA: Office visit, Swelling face — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: The right side of my face is swollen (in front of my ear to beliw my jaw). · Healthcare visit (other): My primary care physician then, a referral to a specialist. Next week, I will be getting a CT Scan.

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-16
Call 1 — Left Voicemail
2022-05-16
Call 1 — Left Voicemail
2022-05-16
Call 1 — Left Voicemail
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-12	Moderna
2	2021-05-10	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-15

Systemic reaction (other): Both of arms are itching at my elbows. They are both red (because of scratching)but, no rash.

2021-04-16

Systemic reaction (other): Rash on both arms on and around elbows.

2021-04-17

Systemic reaction (other): Only on the left arm by the elbow. The right arm rash is gone.

Release 8 — day 21, dose 2

2021-05-31

Symptoms: Headaches

Release 8 — day 28, dose 2

2021-06-07

Symptoms: Headaches

Release 9 — day 42, dose 2

2021-06-21

Symptoms: I have a sinus infection.

Release 9 — 3 months, dose 2

2021-08-09

Symptoms: Sinus infection.

Release 10 — 6 months, dose 2

2021-11-08

Symptoms: Sinus infection

Release 11 — 12 months, dose 2

2022-05-13

Symptoms: The right side of my face is swollen (in front of my ear to beliw my jaw).

Healthcare visit (other): My primary care physician then, a referral to a specialist. Next week, I will be getting a CT Scan.

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	Headache	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Swelling face	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓

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