2JY-13909-74034
3 vaccinations
6 coded responses
28 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 759 / TX
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-01-16
Registered in v-safe
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Oral herpes — Feeling: GoodFree text: Cold soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Hypersensitivity, Oral discomfort, Oral herpes — Feeling: Good · Fatigue or tirednessFree text: Cold sore and slight allergic reaction,swollen bottom lip, 2nd day in a row. Took allergy meds.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Contusion, Eye pain — Feeling: GoodFree text: Painful eye and bruise on stomach, not sure if they are related.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-22
Survey response — day 7, dose 1MedDRA: Abdominal discomfort, Contusion, Eye injury, Ocular hyperaemia, Photophobia, Pre-existing disease — Feeling: GoodFree text: Bruise on.stomach is healing. Left eye is red and light sensitive. I hit myself in the eye and I think this is why. Stating it , just in case it is related somehow. Have had idiopathic eye disorder in the past.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-02-05
- 2021-02-12
- 2021-02-19
-
2021-02-23
Dose 2 — Moderna
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Joint pains, Fatigue or tirednessAdult check-in
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Joint pains, Fatigue or tirednessAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body achesAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-02
-
2021-03-09
Survey response — day 14, dose 2MedDRA: Stomatitis — Feeling: GoodFree text: Sores in my mouth.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — day 21, dose 2MedDRA: Photopsia — Feeling: GoodFree text: Flashes of lights in the corners of my eyes, light bursts.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-05-25
- 2021-08-26
-
2021-10-26
Dose 3 — Moderna
- 2021-10-30
- 2021-10-31
- 2021-11-02
- 2021-11-23
- 2021-12-07
- 2022-01-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Cold sore
Systemic reaction (other): Cold sore and slight allergic reaction,swollen bottom lip, 2nd day in a row. Took allergy meds.
Systemic reaction (other): Painful eye and bruise on stomach, not sure if they are related.
Release 2 — day 7, dose 1
Systemic reaction (other): Bruise on.stomach is healing. Left eye is red and light sensitive. I hit myself in the eye and I think this is why. Stating it , just in case it is related somehow. Have had idiopathic eye disorder in the past.
Release 5 — day 14, dose 2
Symptoms: Sores in my mouth.
Release 5 — day 21, dose 2
Symptoms: Flashes of lights in the corners of my eyes, light bursts.
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 | Photopsia | ✓ | ✓ | ✓ |
| SD | Stomatitis | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ○ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Eye injury | · | · | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Ocular hyperaemia | ✓ | ✓ | ✓ |
| SRO | Oral discomfort | ✓ | ✓ | ✓ |
| SRO | Oral herpes | ✓ | ✓ | ✓ |
| SRO | Photophobia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release