27L-27909-81038

2 vaccinations 11 coded responses 26 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 960 / CA
Registered: 2021-03-16

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Moderna
2021-03-16
Survey response — day 0, dose 1
MedDRA: Vision blurred — Feeling: Fair · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurry Vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Diplopia, Immediate post-injection reaction, Vision blurred — Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: 4 minutes after shot blurry vision and later double vision

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: Ocular discomfort — Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Mild pulling on eyes

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: Dizziness — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, 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 woke up lightheaded/dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Tugging on my eyeball, drank alot of water w no incling to to pee

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling hot, Headache, Muscular weakness, Vomiting — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Vomiting, Diarrhea, Rash, not including the immediate area around the injection site

Free text: At work, temp was normal-I felt hot later legs wobbly later vomiting later then headache mandatory I must not work tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Crying, Emotional disorder, Fatigue, Feeling abnormal, Limb discomfort, Muscular weakness, Pain in extremity — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Wobbly legs aching feel heavy, really fatigued, sensitive feelings... easily to cry

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 7, dose 1
Feeling: Fair · Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-31
Survey response — day 14, dose 1
MedDRA: Fatigue, Limb discomfort — Feeling: Fair

Free text: My vision, my legs feel heavy..I get tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-13
Dose 2 — Moderna
2021-04-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Blood sugar highest ever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, 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've been dizzy/lightheaded since last Moderna shot on 4/14/21 Blood sugar highest every day 185 called my Dr. told this is just side effects give another few days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 7, dose 2
MedDRA: Blood glucose increased, Dizziness, Urticaria — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Lightheaded,blood sugar highest ever, hives, ,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Poor

Adult check-in
2021-05-14
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-13	Moderna

Free text

Release 5 — day 0, dose 1

2021-03-16

Systemic reaction (other): Blurry Vision

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): 4 minutes after shot blurry vision and later double vision

2021-03-18

Systemic reaction (other): Mild pulling on eyes

2021-03-19

Systemic reaction (other): I woke up lightheaded/dizzy

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Tugging on my eyeball, drank alot of water w no incling to to pee

2021-03-21

Systemic reaction (other): At work, temp was normal-I felt hot later legs wobbly later vomiting later then headache mandatory I must not work tomorrow

2021-03-22

Systemic reaction (other): Wobbly legs aching feel heavy, really fatigued, sensitive feelings... easily to cry

Release 6 — day 14, dose 1

2021-03-31

Symptoms: My vision, my legs feel heavy..I get tired

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Blood sugar highest ever

2021-04-19

Systemic reaction (other): I've been dizzy/lightheaded since last Moderna shot on 4/14/21 Blood sugar highest every day 185 called my Dr. told this is just side effects give another few days

Release 7 — day 7, dose 2

2021-04-20

Systemic reaction (other): Lightheaded,blood sugar highest ever, hives, ,

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	Fatigue	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Crying	✓	✓	✓
SRO	Diplopia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Emotional disorder	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Urticaria	✓	✓	✓
SRO	Vision blurred	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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