AVL-81800-64030

3 vaccinations 12 coded responses 39 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 984 / WA
Registered: 2021-01-31

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

2JZ-46317-90479 Child or adolescent in my care · Male · 2021-06-15

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: Injection site pruritus, Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Extreme itching starting at injection site down the entire length of my arm.

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: Unevaluable event — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Feels like the same thing I go through when I get a standard flu vaccine. Just aching a bit all over but nothing serious.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Muscle spasms — Feeling: Fair · Site: Pain · Fever · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Lower back pain and spasms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — day 7, dose 1
MedDRA: Abdominal pain, Back pain, Ear pain — Feeling: Fair · Fever · Joint pains, Fatigue or tiredness · Be unable to work

Free text: Lower back and abdominal pain, ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

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
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 42, dose 2
MedDRA: Lymphadenopathy, Pain in extremity — Feeling: Fair

Free text: Sore arm at 1st dose vaccination site. Swollen lymph glands off and on under same arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-27
Survey response — 12 months, dose 2
MedDRA: COVID-19 — 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: COVID positive

MedDRA releases: 2024-11 · check-in free text available
2022-02-27
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-17
Call 1 — Left Voicemail
2022-03-30
Dose 3 — Moderna
2022-03-31
Survey response — days 1–6 daily, dose 3
MedDRA: Influenza, Tinnitus, Viral infection — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dull humming in my ears, indicative of a flu or virus.

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2022-04-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-04
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain, Sinusitis, Vertigo — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus infection ear ache vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Ear pain, Sinusitis — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Ear ache, sinus infection, caughing

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Survey response — day 7, dose 3
MedDRA: Cough, Ear pain, Sinusitis — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Ear ache, caughing, sinus infection

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-04-20
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-04-27
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-05-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-05-11
Survey response — day 42, dose 3
MedDRA: Bronchitis, Ear infection, Pyrexia, 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: Fever, bronchitis, ear infection, sinus infection.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — day 42, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-12
Call 2 — Left Voicemail
2022-05-12
Call 1 — Left Voicemail
2022-06-29
Survey response — 3 months, dose 3
MedDRA: Headache, Injection site pruritus, Office visit, Respiratory disorder, 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: Increased itching at injection site with no rash. Increased problems as of May 4th, 2022 with breathing, unknown if related to vaccine or not. Saw doctor on or about May 28, 2022. Prescribed antibiotics, prednisone, inhaler. Sinus infection, headache

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-30
Call 3 — Left Voicemail
2022-06-30
Call 2 — Left Voicemail
2022-06-30
Call 1 — Left Voicemail
2022-09-28
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-03-30
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-27	Moderna
3	2022-03-30	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Extreme itching starting at injection site down the entire length of my arm.

2021-02-01

Systemic reaction (other): Feels like the same thing I go through when I get a standard flu vaccine. Just aching a bit all over but nothing serious.

2021-02-04

Systemic reaction (other): Lower back pain and spasms

Release 3 — day 7, dose 1

2021-02-08

Systemic reaction (other): Lower back and abdominal pain, ear pain

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Sore arm at 1st dose vaccination site. Swollen lymph glands off and on under same arm.

Release 11 — 12 months, dose 2

2022-02-27

Symptoms: COVID positive

Release 11 — days 1–6 daily, dose 3

2022-03-31

Systemic reaction (other): Dull humming in my ears, indicative of a flu or virus.

2022-04-04

Systemic reaction (other): Sinus infection ear ache vertigo

2022-04-05

Systemic reaction (other): Ear ache, sinus infection, caughing

Release 11 — day 7, dose 3

2022-04-06

Systemic reaction (other): Ear ache, caughing, sinus infection

Release 11 — day 42, dose 3

2022-05-11

Symptoms: Fever, bronchitis, ear infection, sinus infection.

Release 12 — 3 months, dose 3

2022-06-29

Symptoms: Increased itching at injection site with no rash. Increased problems as of May 4th, 2022 with breathing, unknown if related to vaccine or not. Saw doctor on or about May 28, 2022. Prescribed antibiotics, prednisone, inhaler. Sinus infection, headache cut off by CDC

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	Bronchitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Ear infection	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pruritus	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Influenza	·	·	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sinusitis	·	·	✓
SRO	Tinnitus	·	·	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vertigo	·	·	✓
SRO	Viral infection	·	·	✓

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