6UF-28325-98111

5 vaccinations 8 coded responses 29 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 827 / WY
Registered: 2021-02-18

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

2021-02-16
Dose 1 — Moderna
2021-02-18
Registered in v-safe
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety, Ear pain, Lymphadenopathy, Tremor — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Lymph node under right jaw/ear swollen, pain from there into ear. Starting to get right ear ache. Feel "shaky." Have felt anxious since vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slight sore throat right side up eustachian tube into right ear. Swollen lymph node under right jaw

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Ear disorder, Ear pain, Medical counselling, Oropharyngeal pain, Sinus disorder, Sinus pain — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Still have ear fullness/pain on right. Now in sinus. Somewhat like allergy but only on right side. Slight sore throat on right side. · Healthcare visit (other): Called pharmacy that gave shot for advice on taking allergy meds and if this was a concern

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-22
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Respiratory tract congestion, Sinus congestion — Feeling: Fair · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ear pain/congestion and sinus congestion still bothering me

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 21, dose 1
MedDRA: Nasopharyngitis, Oropharyngeal pain — Feeling: Fair

Free text: I seem to be developing a sore throat. My husband had what appears to have been a cold that he seems to have given to me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Dose 2 — Moderna
2021-03-16
Survey response — day 0, dose 2
MedDRA: Fatigue, Headache, Nasal congestion, Nasopharyngitis — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Am recovering from a cold. Headache, fatigue and stuffy nose/sinuses pre-existed covid shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

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

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Hypotension — Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Low blood pressure. 100/64

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Cardiac discomfort — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Funny heart feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-13
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
2021-04-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Moderna
2022-03-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-03-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-08
Dose 4 — Moderna
2022-11-11
Dose 5 — Moderna
2022-12-10
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-16
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-24
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-10
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-14
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Moderna
2	2021-03-16	Moderna
3	2021-12-10	Moderna	No
4	2022-07-08	Moderna	No
5	2022-11-11	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): Lymph node under right jaw/ear swollen, pain from there into ear. Starting to get right ear ache. Feel "shaky." Have felt anxious since vaccination.

2021-02-20

Systemic reaction (other): Slight sore throat right side up eustachian tube into right ear. Swollen lymph node under right jaw

2021-02-21

Systemic reaction (other): Still have ear fullness/pain on right. Now in sinus. Somewhat like allergy but only on right side. Slight sore throat on right side.

Healthcare visit (other): Called pharmacy that gave shot for advice on taking allergy meds and if this was a concern

2021-02-22

Systemic reaction (other): Ear pain/congestion and sinus congestion still bothering me

Release 5 — day 21, dose 1

2021-03-09

Symptoms: I seem to be developing a sore throat. My husband had what appears to have been a cold that he seems to have given to me.

Release 5 — day 0, dose 2

2021-03-16

Systemic reaction (other): Am recovering from a cold. Headache, fatigue and stuffy nose/sinuses pre-existed covid shot

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Low blood pressure. 100/64

2021-03-21

Systemic reaction (other): Funny heart feeling

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	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Cardiac discomfort	✓	✓	✓
SRO	Ear disorder	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypotension	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Tremor	✓	✓	✓

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