HMJ-82936-43472

3 vaccinations 13 coded responses 25 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 775 / TX
Registered: 2021-02-10

Relationship: Self
Race: N/A
Ethnicity: N/A

Registered dependents

PRE-71480-56029 Child or adolescent in my care · Female · 2021-12-21

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-05
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 7, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 14, dose 1
MedDRA: Chest discomfort, Fatigue, Oropharyngeal pain, Paranasal sinus discomfort, Somnolence, Swelling — Feeling: Good

Free text: Sore throat.Please know at the point of the shot, I experienced fatigue, sleepiness, heavy chest feelings, swelling, sinus and throat irritation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Survey response — day 0, dose 2
MedDRA: Chest discomfort, Ear pain, Oropharyngeal pain, Sinus disorder, Somnolence, Vision blurred — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme sleepiness, blurred vision, sore throat, sinus irritation, left ear ache, and tightness in chest.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Ear pain, Wheezing — 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

Free text: Wheezing, coughing, and ear ache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Sneezing — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Slight cough/sneeze

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Sneezing — Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat and sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Sneezing, Wheezing — Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing, sneezing, and wheezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Survey response — day 14, dose 2
MedDRA: Dizziness, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Light headed and nauseous.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Survey response — 6 months, dose 2
MedDRA: Ear infection, Paranasal sinus inflammation — Feeling: Fair · Be unable to work or attend school

Free text: Ear infectionSinus inflammation

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-20
Dose 3 — Pfizer-BioNTech
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-01-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-19
Survey response — day 28, dose 3
MedDRA: Cough, Sneezing — Feeling: Good

Free text: Sneezing Cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Survey response — day 35, dose 3
MedDRA: Ear pain, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat Ear ache

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Survey response — 6 months, dose 3
MedDRA: Ear infection, Fatigue — Feeling: Poor · 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: Ear infection Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — 6 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)
2022-06-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-04	Moderna
3	2021-12-20	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Sore throat

Release 4 — day 7, dose 1

2021-02-12

Systemic reaction (other): Sore throat

Release 4 — day 14, dose 1

2021-02-19

Symptoms: Sore throat.Please know at the point of the shot, I experienced fatigue, sleepiness, heavy chest feelings, swelling, sinus and throat irritation.

Release 5 — day 0, dose 2

2021-03-04

Systemic reaction (other): Extreme sleepiness, blurred vision, sore throat, sinus irritation, left ear ache, and tightness in chest.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Wheezing, coughing, and ear ache.

2021-03-07

Systemic reaction (other): Slight cough/sneeze

2021-03-08

Systemic reaction (other): Sore throat and sneezing

2021-03-09

Systemic reaction (other): Coughing, sneezing, and wheezing

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Light headed and nauseous.

Release 9 — 6 months, dose 2

2021-09-02

Symptoms: Ear infectionSinus inflammation

Release 10 — day 28, dose 3

2022-01-19

Symptoms: Sneezing Cough

Release 11 — day 35, dose 3

2022-01-24

Symptoms: Sore throat Ear ache

Release 12 — 6 months, dose 3

2022-06-22

Symptoms: Ear infection Fatigue

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	Chest discomfort	✓	✓	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Ear infection	✓	·	✓
SD	Ear pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Paranasal sinus inflammation	✓	·	✓
SD	Sneezing	·	·	✓
SD	Somnolence	✓	✓	✓
SD	Swelling	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Vision blurred	✓	✓	✓
SRO	Wheezing	✓	✓	✓

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