X58-25933-02509

3 vaccinations 8 coded responses 27 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 977 / OR
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
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
2021-01-28
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Good

Free text: Possible ear ache (likely unrelated)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ear canal blockage that occurred after shot, dr predicts could be related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Ear congestion — Feeling: Good

Free text: Inner ear tube congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Inner ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-11
Survey response — day 7, dose 2
MedDRA: Ear discomfort — Feeling: Good · Headache

Free text: Inner ear pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 14, dose 2
MedDRA: Acupuncture, Ear pain, Headache, Lymphadenopathy, Mastication disorder, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: The lymph nodes on my left jaw, neck, and temple are swollen. I have frequent headaches because of it, inner ear pain, and its difficult to chew. It impacts me especially in the mornings. I am going in for my third doctor appointment try to resolv · Healthcare visit (other): Acupuncture

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-04
Survey response — day 28, dose 2
MedDRA: Acupuncture, Headache, Lymphadenopathy — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Continued headaches, swollen lymph nodes on one side of my face. · Healthcare visit (other): Accupuncture

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

1 call case(s)
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

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

Adult check-in
2021-07-26
Call 2 — Left Voicemail
2021-08-02
Call 3 — Left Voicemail
2021-08-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-16
Dose 3 — Pfizer-BioNTech
2022-02-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2023-01-16
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · 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

MedDRA releases: 2024-11
2023-01-16
Report sent to call center — 12 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)
2023-01-17
Call 1 — Left Voicemail
2023-01-17
Call 1 — Left Voicemail
2023-01-17
Call 1 — Left Voicemail
2023-01-17
Call 1 — Left Voicemail
2023-01-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2022-01-16	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-08	Unsuccessful
2021-02-10	Unsuccessful
2021-02-18	Unsuccessful
2021-03-04	Unsuccessful
2023-01-16	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Possible ear ache (likely unrelated)

2021-02-08

Systemic reaction (other): Ear canal blockage that occurred after shot, dr predicts could be related

2021-02-09

Systemic reaction (other): Inner ear tube congestion

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Inner ear pain

Release 4 — day 7, dose 2

2021-02-11

Systemic reaction (other): Inner ear pressure

Release 4 — day 14, dose 2

2021-02-18

Symptoms: The lymph nodes on my left jaw, neck, and temple are swollen. I have frequent headaches because of it, inner ear pain, and its difficult to chew. It impacts me especially in the mornings. I am going in for my third doctor appointment try to resolv

Healthcare visit (other): Acupuncture

Release 5 — day 28, dose 2

2021-03-04

Symptoms: Continued headaches, swollen lymph nodes on one side of my face.

Healthcare visit (other): Accupuncture

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	Acupuncture	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Ear pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Mastication disorder	✓	✓	✓
SD	Office visit	✓	✓	✓
SRO	Ear congestion	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Ear pain	✓	✓	✓

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