YU3-46756-95873

3 vaccinations 6 coded responses 37 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 752 / TX
Registered: 2020-12-29

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-05
Health check-in — day 7, dose 1
Feeling: Poor · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Poor

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-26
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Presyncope, Syncope — Feeling: Good · Site: Pain, Redness · Fever · Chills, Headache

Free text: I had a vasovagal reaction within 5 minutes of the second dose and nearly passed out in observation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash, Rash — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: I have a rash on my left foot that is similar to the one on my arm at the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Diarrhea

Adult check-in
2021-02-02
Survey response — day 7, dose 2
MedDRA: Eye pruritus, Ocular hyperaemia — Feeling: Fair · Site: Redness, Itching · Fever · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Itchy red left eye (white of eye)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — day 14, dose 2
MedDRA: Ear pain, Oral herpes — Feeling: Fair

Free text: Ear acheFever blister

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — day 21, dose 2
MedDRA: Acne, Anxiety, Depression, Oral herpes, Pain of skin — Feeling: Fair

Free text: Cold soresSores on scalpAcneDepression and anxiety have increased in severity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — day 28, dose 2
MedDRA: Headache, Oral herpes, Pre-existing disease, Skin papilloma — Feeling: Fair

Free text: New cold sores on lips and warts on fingers. I have had daily moderate to severe headaches since my first dose in December. I have also experienced increased anxiety and worsening depression after both doses.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Dose 3 — Moderna
2021-09-03
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-09-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-09-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-09-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-09-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-09-12
Health check-in — day 7, dose 3
Feeling: Good · Chills

Adult check-in
2021-09-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-11
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-10-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-09-03
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-09-03	Moderna	No

Free text

Release 2 — day 0, dose 2

2021-01-26

Systemic reaction (other): I had a vasovagal reaction within 5 minutes of the second dose and nearly passed out in observation.

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): I have a rash on my left foot that is similar to the one on my arm at the injection site

Release 3 — day 7, dose 2

2021-02-02

Systemic reaction (other): Itchy red left eye (white of eye)

Release 3 — day 14, dose 2

2021-02-09

Symptoms: Ear acheFever blister

Release 4 — day 21, dose 2

2021-02-21

Symptoms: Cold soresSores on scalpAcneDepression and anxiety have increased in severity

Release 4 — day 28, dose 2

2021-02-23

Symptoms: New cold sores on lips and warts on fingers. I have had daily moderate to severe headaches since my first dose in December. I have also experienced increased anxiety and worsening depression after both doses.

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	Acne	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Oral herpes	✓	✓	✓
SD	Pain of skin	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Skin papilloma	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Presyncope	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Syncope	✓	✓	✓

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