6VR-29594-07690

4 vaccinations 10 coded responses 37 check-ins 8 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 787 / TX
Registered: 2021-01-04

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Moderna
2021-01-04
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash seems to be around my neck and face .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — day 7, dose 2
MedDRA: Eyelid irritation, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash is still around my neck and my eyes have itchy, welts on the eyelids

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Survey response — day 28, dose 2
MedDRA: Pruritus, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have itchy welts on my eyelids (they actually began on 2/6 and I kept forgetting to report it to yall)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-08
Survey response — day 35, dose 2
MedDRA: Eyelid rash, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rash/welts on my eye lids still present and now seems to be spreading to underneath right eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Survey response — day 42, dose 2
MedDRA: Eyelid rash, Rash — Feeling: Fair

Free text: Rash in eye kids and around the eyes has gotten worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Callback requested for
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Breast cancer, Sinusitis — Feeling: Fair · Be unable to work or attend school, 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: Diagnoses with Breast Cancer in AprilDiagnosed with Sinus Infection July 17

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
Report sent to call center — 6 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)
2021-08-10
Callback requested for
2021-08-10
Callback requested for
2021-08-10
Call 1 — Left Voicemail
2021-09-16
Dose 3 — Moderna
2022-02-03
Survey response — 12 months, dose 2
MedDRA: Headache, Oropharyngeal pain — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Currently I have a sore throat and headache

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-07
Call 1 — Left Voicemail
2022-02-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-11-10
Dose 4 — Pfizer-BioNTech
2022-11-10
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

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

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-17
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-08
Survey response — day 28, dose 4
MedDRA: Asthenia, Headache — Feeling: Fair

Free text: Headache and decreased energy

MedDRA releases: 2024-11 · check-in free text available
2022-12-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-09
Survey response — 3 months, dose 4
MedDRA: Cough, Paranasal sinus hypersecretion, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-02-09
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-02-10
Call 1 — Left Voicemail
2023-02-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-11
Survey response — 6 months, dose 4
MedDRA: Cough, Eye pruritus, Lacrimation increased, Sinus congestion — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-05-11
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-12
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-01	Moderna
3	2021-09-16	Moderna	No
4	2022-11-10	Pfizer-BioNTech	No

Call center

6 call center cases

5 successful · 1 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Rash seems to be around my neck and face .

Release 3 — day 7, dose 2

2021-02-08

Systemic reaction (other): Rash is still around my neck and my eyes have itchy, welts on the eyelids

Release 4 — day 28, dose 2

2021-03-01

Symptoms: I have itchy welts on my eyelids (they actually began on 2/6 and I kept forgetting to report it to yall)

Release 5 — day 35, dose 2

2021-03-08

Symptoms: Rash/welts on my eye lids still present and now seems to be spreading to underneath right eye

Release 5 — day 42, dose 2

2021-03-15

Symptoms: Rash in eye kids and around the eyes has gotten worse.

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Diagnoses with Breast Cancer in AprilDiagnosed with Sinus Infection July 17

Release 11 — 12 months, dose 2

2022-02-03

Symptoms: Currently I have a sore throat and headache

Release 12 — day 28, dose 4

2022-12-08

Symptoms: Headache and decreased energy

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
SD	Asthenia	·	·	✓
SD	Breast cancer	✓	·	✓
SD	Cough	·	·	✓
SD	Eye pruritus	·	·	✓
SD	Eyelid rash	✓	✓	✓
SD	Headache	·	·	✓
SD	Lacrimation increased	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinusitis	✓	·	✓
SD	Urticaria	✓	✓	✓
SRO	Eyelid irritation	✓	✓	✓
SRO	Rash	✓	✓	✓

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