6UY-20299-16768

3 vaccinations 16 coded responses 38 check-ins 16 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 297 / SC
Registered: 2021-01-31

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

2021-01-30
Dose 1 — Moderna
2021-01-31
Registered in v-safe
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in jaw, Toothache — Feeling: Fair · Site: Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Teeth and jaws hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Epistaxis, Eye pruritus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Dry/scratchy eyes, mild nose bleeds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Epistaxis, Eye irritation — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dry burning eyes, mild nose bleeds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Good

Free text: Pain in left ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Office visit — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Left ear pain · Healthcare visit (other): ENT

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

1 call case(s)
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Ear, nose and throat examination, Office visit — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Left ear pain · Healthcare visit (other): Office visit, ENT

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-13
Survey response — day 14, dose 1
MedDRA: Ear pain, Lymphadenopathy — Feeling: Good

Free text: Ear pain, swollen glands in neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 21, dose 1
MedDRA: Dyspnoea, Ear pain, Hernia, Throat irritation, Upper-airway cough syndrome — Feeling: Good

Free text: Silent reflux from paraesophageal hernia: burning throat, ear ache, post-nasal drip. Hernia large and causes shortness of breath. Surgery in 4 weeks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, 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: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral coldness — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Cold feet/toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Survey response — day 35, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Surgery for paraesophageal hernia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-10
Survey response — day 42, dose 2
MedDRA: Surgery — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Surgery for paraesophageal hernia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
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)
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-08
Call 1 — Could Not Reach Participant
2021-06-08
Call 1 — Could Not Reach Participant
2021-06-08
Call 1 — Could Not Reach Participant
2021-06-08
Call 1 — Could Not Reach Participant
2021-06-11
Call 2 — Could Not Reach Participant
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-18
Dose 3 — Moderna
2021-09-20
Survey response — days 1–6 daily, dose 3
MedDRA: Tremor — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Extreme shaking

MedDRA releases: 2024-11 · check-in free text available
2021-09-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-09-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2021-09-23
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema — Feeling: Good

Free text: Woke up with red nose like a sunburn, but had not been outside

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-09-25
Survey response — day 7, dose 3
MedDRA: Erythema — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Red nose again today

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Health check-in — day 14, dose 3
Feeling: Good

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

Adult check-in
2021-10-16
Survey response — day 28, dose 3
MedDRA: Office visit, Vulvitis — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Vulvar vestibulitis · Healthcare visit (other): In office consultation and labs

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-20
Call 1 — Left Voicemail
2021-10-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-19
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-18
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-27	Moderna
3	2021-09-18	Moderna	No

Call center

5 call center cases

5 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Teeth and jaws hurt

2021-02-01

Systemic reaction (other): Dry/scratchy eyes, mild nose bleeds

2021-02-02

Systemic reaction (other): Dry burning eyes, mild nose bleeds

2021-02-03

Systemic reaction (other): Pain in left ear

2021-02-04

Systemic reaction (other): Left ear pain

Healthcare visit (other): ENT

2021-02-05

Systemic reaction (other): Left ear pain

Healthcare visit (other): Office visit, ENT

Release 4 — day 14, dose 1

2021-02-13

Symptoms: Ear pain, swollen glands in neck

Release 4 — day 21, dose 1

2021-02-20

Symptoms: Silent reflux from paraesophageal hernia: burning throat, ear ache, post-nasal drip. Hernia large and causes shortness of breath. Surgery in 4 weeks

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Shortness of breath

2021-03-01

Systemic reaction (other): Cold feet/toes

Release 6 — day 35, dose 2

2021-04-03

Symptoms: Surgery for paraesophageal hernia

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Surgery for paraesophageal hernia

Release 9 — days 1–6 daily, dose 3

2021-09-20

Systemic reaction (other): Extreme shaking

2021-09-23

Systemic reaction (other): Woke up with red nose like a sunburn, but had not been outside

Release 9 — day 7, dose 3

2021-09-25

Systemic reaction (other): Red nose again today

Release 10 — day 28, dose 3

2021-10-16

Symptoms: Vulvar vestibulitis

Healthcare visit (other): In office consultation and labs

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	Ear, nose and throat examination	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Hernia	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Surgery	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SD	Vulvitis	·	·	✓
SRO	Dry eye	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Erythema	·	·	✓
SRO	Eye irritation	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Tremor	·	·	✓

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