ZDS-97193-47580

3 vaccinations 13 coded responses 39 check-ins 13 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 038 / NH
Registered: 2021-04-16

Relationship: Self
Race: Asian
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

2021-04-16
Registered in v-safe
2021-04-16
Dose 1 — Moderna
2021-04-16
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 1
MedDRA: Mouth swelling, Swelling face — Feeling: Good

Free text: I thought right side of my cheek near the mouth was a little puffy after morning shower but by the night fall it seems ok

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-23
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-14
Dose 2 — Moderna
2021-05-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Good · Site: Redness · Fever

Free text: Yesterday 5/15 I forgot to report I had fever up to 100 F

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Head discomfort — Feeling: Good · Site: Redness, Swelling · Fever

Free text: Not headache but my head feel heavy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort — Feeling: Fair · Site: Swelling · Fever · Fatigue or tiredness

Free text: Tightness of chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — days 1–6 daily, dose 2
MedDRA: Seasonal allergy, Swelling face — Feeling: Fair · Fever

Free text: My face is puffy since yesterday especially around my mouth. I have OAS the vaccine might effect it. Also I had running nose this morning very bad I couldn't stop it but I'm afraid that's bc seasonal allergy kicked in

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea, Swelling face — Feeling: Fair · Fever · Fatigue or tiredness

Free text: My face is still puffy...no running nose like yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 7, dose 2
MedDRA: Swelling face — Feeling: Fair · Fever · Chills, Fatigue or tiredness

Free text: My cheeks are still puffy a little bit but better than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-18
Survey response — day 35, dose 2
MedDRA: Brain fog, Chills, Depression, Dizziness, Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Foggy light headed slight headache occasionally chill depressed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-22
Dose 3 — Moderna
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Oral mucosal blistering, Oral mucosal eruption — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Blister and bumps in mouth

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fever · None

Adult check-in
2021-12-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fever · None

Adult check-in
2021-12-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-05
Health check-in — day 14, dose 3
Feeling: Good

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

Adult check-in
2022-01-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — day 35, dose 3
MedDRA: Chest discomfort, Oropharyngeal pain, Pyrexia — Feeling: Fair

Free text: Fever , chest tightness, soar throat

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Survey response — day 42, dose 3
MedDRA: Body temperature fluctuation, Body temperature increased — Feeling: Fair

Free text: Still have fever coming and going....it's 99.5 F highest today my regular temp is 97.7 seems like I have fever not evey day but more often .but no problem doing every day choir or work

MedDRA releases: 2024-11 · check-in free text available
2022-03-23
Survey response — 3 months, dose 3
MedDRA: Muscle spasms, Tympanic membrane disorder — Feeling: Good

Free text: Sometime my right eardrum vibrates / spasms

MedDRA releases: 2024-11 · check-in free text available
2022-06-24
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-12-22
Survey response — 12 months, dose 3
MedDRA: Blood test abnormal, Glucose tolerance impaired — Feeling: Good

Free text: My blood test shows I'm in Pre diabetic label

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-16	Moderna
2	2021-05-14	Moderna
3	2021-12-22	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-18

Systemic reaction (other): I thought right side of my cheek near the mouth was a little puffy after morning shower but by the night fall it seems ok

Release 8 — days 1–6 daily, dose 2

2021-05-16

Systemic reaction (other): Yesterday 5/15 I forgot to report I had fever up to 100 F

2021-05-17

Systemic reaction (other): Not headache but my head feel heavy

2021-05-18

Systemic reaction (other): Tightness of chest

2021-05-19

Systemic reaction (other): My face is puffy since yesterday especially around my mouth. I have OAS the vaccine might effect it. Also I had running nose this morning very bad I couldn't stop it but I'm afraid that's bc seasonal allergy kicked in

2021-05-20

Systemic reaction (other): My face is still puffy...no running nose like yesterday

Release 8 — day 7, dose 2

2021-05-21

Systemic reaction (other): My cheeks are still puffy a little bit but better than yesterday

Release 9 — day 35, dose 2

2021-06-18

Symptoms: Foggy light headed slight headache occasionally chill depressed

Release 10 — days 1–6 daily, dose 3

2021-12-23

Systemic reaction (other): Blister and bumps in mouth

Release 11 — day 35, dose 3

2022-01-26

Symptoms: Fever , chest tightness, soar throat

Release 11 — day 42, dose 3

2022-02-02

Symptoms: Still have fever coming and going....it's 99.5 F highest today my regular temp is 97.7 seems like I have fever not evey day but more often .but no problem doing every day choir or work

Release 11 — 3 months, dose 3

2022-03-23

Symptoms: Sometime my right eardrum vibrates / spasms

Release 12 — 12 months, dose 3

2022-12-22

Symptoms: My blood test shows I'm in Pre diabetic label

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	Blood test abnormal	·	·	✓
SD	Body temperature fluctuation	·	·	✓
SD	Body temperature increased	·	·	✓
SD	Brain fog	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Chills	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Glucose tolerance impaired	·	·	✓
SD	Headache	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Tympanic membrane disorder	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Mouth swelling	✓	✓	✓
SRO	Oral mucosal blistering	·	·	✓
SRO	Oral mucosal eruption	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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