2EY-30083-43844
4 vaccinations
8 coded responses
21 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 926 / CA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-12
Dose 1 — Janssen/Johnson & Johnson
-
2021-04-13
Registered in v-safe
-
2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · HeadacheFree text: My headaches (more pressure than pain) began 4/12/21 later after injection, had it today 4/13/21 a few times lasting a few minutes only.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-14
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: No symptoms today at all.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: GoodFree text: Super mild headache-like pressure. It went away when I drank a mixture of Apple juice and Carrot juice. We heard that these two juices combined were helpful to people in (b)(6) and boy, try and see for yourself.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Self-medication — Feeling: Good · HeadacheFree text: Very mild headache on and off. I finally took one Aspirin today just to be safe.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-17
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: I am feeling excellent today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
- 2021-04-19
-
2021-04-26
Survey response — day 14, dose 1MedDRA: Eye pain, Self-medication — Feeling: GoodFree text: I experienced minor pains behind the area of both my eyeballs. Years ago I had problems with retina degeneration and I had laser procedure done on I believe one eye. This was around 1997-8. So, I took an aspirin and didnt experience the pain agaiMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
-
2021-07-12
Survey response — 3 months, dose 1MedDRA: Abdominal pain, Syncope — Feeling: GoodFree text: I vaccinated 4/12/2021. Since July 9th Ive been having a very faint pain about 3 inches below my ribs (between side and center) on the right side of my abdomen. No other accompanying symptoms. I cannot claim it is from the vaccine but informingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-11
-
2021-11-09
Dose 2 — Moderna
- 2022-04-12
-
2022-04-19
Dose 3 — Moderna
-
2022-09-30
Dose 4 — Moderna
- 2022-10-27
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-12-30
-
2023-04-07
Survey response — 6 months, dose 4MedDRA: Cough, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, Sneezing — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-12 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-09 | Moderna | No |
| 3 | 2022-04-19 | Moderna | No |
| 4 | 2022-09-30 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): My headaches (more pressure than pain) began 4/12/21 later after injection, had it today 4/13/21 a few times lasting a few minutes only.
Systemic reaction (other): No symptoms today at all.
Systemic reaction (other): Super mild headache-like pressure. It went away when I drank a mixture of Apple juice and Carrot juice. We heard that these two juices combined were helpful to people in (b)(6) and boy, try and see for yourself.
redacted (b)(6)
Systemic reaction (other): Very mild headache on and off. I finally took one Aspirin today just to be safe.
Systemic reaction (other): I am feeling excellent today.
Release 8 — day 14, dose 1
Symptoms: I experienced minor pains behind the area of both my eyeballs. Years ago I had problems with retina degeneration and I had laser procedure done on I believe one eye. This was around 1997-8. So, I took an aspirin and didnt experience the pain agai
Release 9 — 3 months, dose 1
Symptoms: I vaccinated 4/12/2021. Since July 9th Ive been having a very faint pain about 3 inches below my ribs (between side and center) on the right side of my abdomen. No other accompanying symptoms. I cannot claim it is from the vaccine but informing
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 | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Eye pain | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Syncope | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release