YW3-15701-89630

5 vaccinations 11 coded responses 48 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 152 / PA
Registered: 2021-03-17

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

2021-03-14
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Inflammation — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sinus inflammation (may be spring allergies re-emerging)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Ear congestion — Feeling: Good · Site: Redness

Free text: slight ear congestion. Forgot to report it for also yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site erythema, Rash macular — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Free text: Blotchy red around injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Nausea

Adult check-in
2021-03-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Sinus disorder — Feeling: Fair · Site: Redness, Swelling · Fever

Free text: Swollen right sinus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Survey response — day 7, dose 2
MedDRA: Oropharyngeal pain, Swollen tongue — Feeling: Fair · Muscle or body aches, Nausea

Free text: Swollen tongue. Sore throat (yesterday too)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Oropharyngeal pain, Respiratory tract congestion, Upper-airway cough syndrome — Feeling: Fair

Free text: Sore throatPost nasal dripChest congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-20
Dose 3 — Moderna
2022-04-10
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Dose 4 — Moderna
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness · None

Adult check-in
2022-05-06
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-05-13
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-27
Survey response — day 28, dose 4
MedDRA: Skin disorder — Feeling: Fair

Free text: Skin condition in corner of eye. Don't know if it's related to vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Survey response — day 42, dose 4
MedDRA: Fatigue, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever and exhaustion

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-28
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-11-10
Dose 5 — Moderna
Co-administered: Flu
2022-11-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-11-13
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-14
Survey response — days 1–6 daily, dose 5
MedDRA: Depressed mood — Feeling: Poor · Be unable to work or attend school

Free text: Low mood

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-17
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-11-24
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-08
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-15
Survey response — day 35, dose 5
MedDRA: Abdominal pain lower, Pain — Feeling: Fair

Free text: I feel a steady dull pain in lower abdomen which may or may not be related

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-02-11
Survey response — 3 months, dose 5
MedDRA: Blepharitis, Eye inflammation, Eye irritation — Feeling: Fair

MedDRA releases: 2024-11
2023-05-13
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-14	Moderna
2	2021-04-10	Moderna
3	2021-12-20	Moderna	No
4	2022-04-29	Moderna	No
5	2022-11-10	Moderna	Flu

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Sinus inflammation (may be spring allergies re-emerging)

2021-03-18

Systemic reaction (other): slight ear congestion. Forgot to report it for also yesterday

Release 6 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Blotchy red around injection site

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Swollen right sinus

Release 7 — day 7, dose 2

2021-04-17

Systemic reaction (other): Swollen tongue. Sore throat (yesterday too)

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Sore throatPost nasal dripChest congestion

Release 11 — day 28, dose 4

2022-05-27

Symptoms: Skin condition in corner of eye. Don't know if it's related to vaccine

Release 12 — day 42, dose 4

2022-06-10

Symptoms: Fever and exhaustion

Release 12 — days 1–6 daily, dose 5

2022-11-14

Systemic reaction (other): Low mood

Release 12 — day 35, dose 5

2022-12-15

Symptoms: I feel a steady dull pain in lower abdomen which may or may not be related

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	Abdominal pain lower	·	·	✓
SD	Blepharitis	·	·	✓
SD	Eye inflammation	·	·	✓
SD	Eye irritation	·	·	✓
SD	Fatigue	·	·	✓
SD	Nasal congestion	○	○	○
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Skin disorder	·	·	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SRO	Depressed mood	·	·	✓
SRO	Ear congestion	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Swollen tongue	✓	✓	✓

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