ZJ6-25307-07411

5 vaccinations 20 coded responses 57 check-ins 20 free-text entries 0 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 553 / MN
Registered: 2021-03-31

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

2021-03-30
Dose 1 — Moderna
2021-03-31
Registered in v-safe
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-27
Dose 2 — Moderna
2021-04-27
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-18
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Regular headaches. Unsure whether it is related to the vaccine or not.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-27
Survey response — 3 months, dose 2
MedDRA: Pre-existing disease, Tinnitus — Feeling: Good

Free text: Tinnitus. Prior to the vaccine, I had tinnitus once or twice a year. Since a few weeks after vaccine, i have ut almost daily.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-02
Dose 3 — Pfizer-BioNTech
2021-11-02
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate increased — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Free text: Fast heartbeat

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Nausea

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Palpitations — Feeling: Fair · Headache, Nausea

Free text: Racing heartbeat each day, better today

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good · Headache

Free text: Ringing in ears.

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Survey response — day 7, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — day 14, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears is more intense.

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Survey response — day 21, dose 3
MedDRA: Pre-existing disease, Tinnitus — Feeling: Good

Free text: Ringing in ears has increased and is persistent.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-14
Survey response — day 42, dose 3
MedDRA: Tinnitus — Feeling: Fair

Free text: Intensified and constant ringing in ears.

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-05
Dose 4 — Pfizer-BioNTech
2022-05-05
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-05-05
Health check-in — day 0, dose 4
Feeling: Fair · Fever · Chills, Fatigue or tiredness

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-09
Survey response — days 1–6 daily, dose 4
MedDRA: Reaction to previous exposure to any vaccine, Tinnitus — Feeling: Good

Free text: Ringing in my ears. I have had this after each Covid shot.

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Survey response — days 1–6 daily, dose 4
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Survey response — days 1–6 daily, dose 4
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — day 7, dose 4
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — day 14, dose 4
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Survey response — day 21, dose 4
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-04
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-26
Dose 5 — Pfizer-BioNTech
2022-11-03
Survey response — day 35, dose 5
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears.

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Survey response — 6 months, dose 4
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ears since latest vaccination on 09/26/2022.

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-26
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-27
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Moderna
2	2021-04-27	Moderna
3	2021-11-02	Pfizer-BioNTech	No
4	2022-05-05	Pfizer-BioNTech	No
5	2022-09-26	Pfizer-BioNTech	No

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): Loss of appetite

Release 8 — day 21, dose 2

2021-05-18

Symptoms: Regular headaches. Unsure whether it is related to the vaccine or not.

Release 9 — 3 months, dose 2

2021-07-27

Symptoms: Tinnitus. Prior to the vaccine, I had tinnitus once or twice a year. Since a few weeks after vaccine, i have ut almost daily.

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): Fast heartbeat

2021-11-05

Systemic reaction (other): Racing heartbeat each day, better today

2021-11-06

Systemic reaction (other): Ringing in ears.

2021-11-07

Systemic reaction (other): Ringing in ears

2021-11-08

Systemic reaction (other): Ringing in ears

Release 10 — day 7, dose 3

2021-11-09

Systemic reaction (other): Ringing in ears

Release 10 — day 14, dose 3

2021-11-16

Symptoms: Ringing in ears is more intense.

Release 10 — day 21, dose 3

2021-11-23

Symptoms: Ringing in ears has increased and is persistent.

Release 10 — day 42, dose 3

2021-12-14

Symptoms: Intensified and constant ringing in ears.

Release 11 — days 1–6 daily, dose 4

2022-05-09

Systemic reaction (other): Ringing in my ears. I have had this after each Covid shot.

2022-05-10

Systemic reaction (other): Ringing in ears.

2022-05-11

Systemic reaction (other): Ringing in ears

Release 11 — day 7, dose 4

2022-05-12

Systemic reaction (other): Ringing in ears

Release 11 — day 14, dose 4

2022-05-19

Symptoms: Ringing in ears

Release 11 — day 21, dose 4

2022-05-26

Symptoms: Ringing in ears

Release 12 — 6 months, dose 4

2022-11-03

Symptoms: Ringing in ears since latest vaccination on 09/26/2022.

Release 12 — day 35, dose 5

2022-11-03

Symptoms: Ringing in ears.

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	Headache	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Tinnitus	✓	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Heart rate increased	·	·	✓
SRO	Palpitations	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Tinnitus	·	·	✓

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