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LSZ-55546-06586

6 vaccinations 12 coded responses 43 check-ins 11 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
616 / IL
Registered
2021-02-08
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-12
    Dose 1 — Moderna
  2. 2021-02-08
    Registered in v-safe
  3. 2021-02-09
    Dose 2 — Moderna
  4. 2021-02-09
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  5. 2021-02-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills, Nausea
    Adult check-in
  6. 2021-02-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  7. 2021-02-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Ear discomfort — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stuffed ears for several days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-02-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Ear discomfort — Feeling: Good · Fatigue or tiredness
    Free text: Stuffy ears
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Ear discomfort — Feeling: Good · Fatigue or tiredness
    Free text: Stuffy ears
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-16
    Survey response — day 7, dose 2
    MedDRA: Ear discomfort — Feeling: Good · Fatigue or tiredness
    Free text: Stuffy ears, particularly the one on the same side as my shot was.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-03-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-18
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  16. 2021-03-23
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-05-11
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-08-10
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-08-14
    Dose 3 — Moderna
  20. 2021-11-13
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  21. 2022-01-15
    Dose 4 — Moderna
  22. 2022-02-12
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  23. 2022-05-15
    Dose 5 — Moderna
  24. 2022-05-17
    Survey response — days 1–6 daily, dose 5
    MedDRA: Ear congestion — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stuffy ears
    MedDRA releases: 2024-11 · check-in free text available
  25. 2022-05-18
    Survey response — days 1–6 daily, dose 5
    MedDRA: Ear congestion — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stuffy ears
    MedDRA releases: 2024-11 · check-in free text available
  26. 2022-05-19
    Survey response — days 1–6 daily, dose 5
    MedDRA: Ear congestion — Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stuffy ears
    MedDRA releases: 2024-11 · check-in free text available
  27. 2022-05-20
    Survey response — days 1–6 daily, dose 5
    MedDRA: Ear congestion — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stuffy ears
    MedDRA releases: 2024-11 · check-in free text available
  28. 2022-05-21
    Survey response — days 1–6 daily, dose 5
    MedDRA: Ear congestion — Feeling: Good · Fatigue or tiredness
    Free text: Stuffy ears
    MedDRA releases: 2024-11 · check-in free text available
  29. 2022-05-22
    Health check-in — day 7, dose 5
    Feeling: Fair · Headache · Be unable to do your normal daily activities
    Adult check-in
  30. 2022-05-29
    Survey response — day 14, dose 5
    MedDRA: Lymphadenopathy, Self-medication — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Swollen lymph nodes (bilateral) sides of breasts and, to a lesser degree, under both armpits. Taking tylenol/ibuprofen & using ice for pain relief.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2022-06-05
    Health check-in — day 21, dose 5
    Feeling: Good
    Adult check-in
  32. 2022-06-12
    Health check-in — day 28, dose 5
    Feeling: Fair
    Adult check-in
  33. 2022-06-19
    Health check-in — day 35, dose 5
    Feeling: Fair
    Adult check-in
  34. 2022-06-26
    Health check-in — day 42, dose 5
    Feeling: Fair
    Adult check-in
  35. 2022-08-14
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  36. 2022-09-30
    Dose 6 — Pfizer-BioNTech
    Co-administered: Flu
  37. 2022-10-01
    Health check-in — days 1–6 daily, dose 6
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  38. 2022-10-02
    Health check-in — days 1–6 daily, dose 6
    Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  39. 2022-10-03
    Health check-in — days 1–6 daily, dose 6
    Feeling: Good · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  40. 2022-10-04
    Health check-in — days 1–6 daily, dose 6
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  41. 2022-10-05
    Health check-in — days 1–6 daily, dose 6
    Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  42. 2022-10-06
    Health check-in — days 1–6 daily, dose 6
    Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  43. 2022-10-07
    Health check-in — day 7, dose 6
    Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  44. 2022-10-14
    Health check-in — day 14, dose 6
    Feeling: Good
    Adult check-in
  45. 2022-10-21
    Survey response — day 21, dose 6
    MedDRA: Injection site pruritus — Feeling: Good
    Free text: Several days of itchy arm where the covid shot was given.
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-10-28
    Health check-in — day 28, dose 6
    Feeling: Good
    Adult check-in
  47. 2022-11-04
    Health check-in — day 35, dose 6
    Feeling: Good
    Adult check-in
  48. 2022-11-11
    Health check-in — day 42, dose 6
    Feeling: Good
    Adult check-in
  49. 2023-01-01
    Health check-in — 3 months, dose 6
    Feeling: Good
    Adult check-in
  50. 2023-03-31
    Survey response — 6 months, dose 6
    MedDRA: COVID-19, Office visit, Postmenopausal haemorrhage, Uterine dilation and curettage — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    MedDRA releases: 2024-11
  51. 2023-03-31
    Report sent to call center — 6 months, dose 6
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  52. 2023-04-03

Vaccinations

DoseDateManufacturerCo-administered
12021-01-12Moderna
22021-02-09Moderna
32021-08-14Moderna No
42022-01-15Moderna No
52022-05-15Moderna No
62022-09-30Pfizer-BioNTech Flu

Call center

ReportedOutcomeVAERS-related outcome
2023-03-31 Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Stuffed ears for several days

2021-02-14

Systemic reaction (other): Stuffy ears

2021-02-15

Systemic reaction (other): Stuffy ears

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): Stuffy ears, particularly the one on the same side as my shot was.

Release 11 — days 1–6 daily, dose 5

2022-05-17

Systemic reaction (other): Stuffy ears

2022-05-18

Systemic reaction (other): Stuffy ears

2022-05-19

Systemic reaction (other): Stuffy ears

2022-05-20

Systemic reaction (other): Stuffy ears

2022-05-21

Systemic reaction (other): Stuffy ears

Release 11 — day 14, dose 5

2022-05-29

Symptoms: Swollen lymph nodes (bilateral) sides of breasts and, to a lesser degree, under both armpits. Taking tylenol/ibuprofen & using ice for pain relief.

Release 12 — day 21, dose 6

2022-10-21

Symptoms: Several days of itchy arm where the covid shot was given.

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
HCVOUterine dilation and curettage · · ✓
SDCOVID-19 · · ✓
SDInjection site pruritus · · ✓
SDLymphadenopathy · · ✓
SDPostmenopausal haemorrhage · · ✓
SDSelf-medication · · ✓
SROEar congestion ○ ○ ✓
SROEar discomfort ✓ ✓ ✓

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

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