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2DE-20216-31102

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
480 / MI
Registered
2021-03-23
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
KVX-17685-60153 Child or adolescent in my care · Male · 2021-06-27

Timeline

  1. 2021-03-23
    Registered in v-safe
  2. 2021-03-23
    Dose 1 — Moderna
  3. 2021-03-23
    Survey response — day 0, dose 1
    MedDRA: Hypoaesthesia eye, Paraesthesia — Feeling: Fair · Site: Pain
    Free text: Tingling back of head and numbness around eye socket - this has been an unexplained sporadic issue on & off
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-27
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dizziness — Feeling: Fair · Headache
    Free text: Lightheaded a little
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-30
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-04-06
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-13
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-20
    Dose 2 — Moderna
  14. 2021-04-20
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches
    Adult check-in
  15. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Adult check-in
  16. 2021-04-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  17. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease, Tinnitus — Feeling: Good
    Free text: My tinnitus (prev condition) seems louder and more constant since shot 2
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease, Tinnitus — Feeling: Good
    Free text: The tinnitus seems really loud. I sporadically had this before but since the shot its definitely more prevalent
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-27
    Survey response — day 7, dose 2
    MedDRA: Back pain, Tinnitus — Feeling: Good
    Free text: Have had very slight lower back pain ever since the second shot. Like kidney area. But quite manageable. And ongoing tinnitus
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-05-04
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-11
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-18
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-25
    Survey response — day 35, dose 2
    MedDRA: Immediate post-injection reaction, Tinnitus — Feeling: Good
    Free text: Nothing new or worsening since the shot. But the ringing tinnitus is still stronger. Could be allergy or weather related, but I know it intensified immediately after the second shot and has not calmed down yet...
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-06-01
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-23Moderna
22021-04-20Moderna

Free text

Release 6 — day 0, dose 1

2021-03-23

Systemic reaction (other): Tingling back of head and numbness around eye socket - this has been an unexplained sporadic issue on & off

Release 6 — days 1–6 daily, dose 1

2021-03-27

Systemic reaction (other): Lightheaded a little

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): My tinnitus (prev condition) seems louder and more constant since shot 2

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): The tinnitus seems really loud. I sporadically had this before but since the shot its definitely more prevalent

Release 8 — day 7, dose 2

2021-04-27

Systemic reaction (other): Have had very slight lower back pain ever since the second shot. Like kidney area. But quite manageable. And ongoing tinnitus

Release 8 — day 35, dose 2

2021-05-25

Symptoms: Nothing new or worsening since the shot. But the ringing tinnitus is still stronger. Could be allergy or weather related, but I know it intensified immediately after the second shot and has not calmed down yet...

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

FieldPreferred term2021-092023-042024-11
SDImmediate post-injection reaction ✓ ✓ ✓
SDTinnitus ✓ ✓ ✓
SROBack pain ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROHypoaesthesia eye ✓ ✓ ✓
SROParaesthesia ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROTinnitus ✓ ✓ ✓

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

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