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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

  1. 2021-01-15
    Dose 1 — Moderna
  2. 2021-01-16
    Registered in v-safe
  3. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  4. 2021-01-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Oral herpes — Feeling: Good
    Free text: Cold sore
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hypersensitivity, Oral discomfort, Oral herpes — Feeling: Good · Fatigue or tiredness
    Free 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
  6. 2021-01-21
    Survey response — days 1–6 daily, dose 1
    MedDRA: Contusion, Eye pain — Feeling: Good
    Free 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
  7. 2021-01-22
    Survey response — day 7, dose 1
    MedDRA: Abdominal discomfort, Contusion, Eye injury, Ocular hyperaemia, Photophobia, Pre-existing disease — Feeling: Good
    Free 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
  8. 2021-01-29
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-05
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-12
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-19
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-23
    Dose 2 — Moderna
  13. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  14. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Joint pains, Fatigue or tiredness
    Adult check-in
  15. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Joint pains, Fatigue or tiredness
    Adult check-in
  16. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache, Muscle or body aches
    Adult check-in
  17. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  18. 2021-03-02
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  19. 2021-03-09
    Survey response — day 14, dose 2
    MedDRA: Stomatitis — Feeling: Good
    Free text: Sores in my mouth.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-03-16
    Survey response — day 21, dose 2
    MedDRA: Photopsia — Feeling: Good
    Free 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
  21. 2021-03-23
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-30
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-06
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-08-26
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-10-26
    Dose 3 — Moderna
  27. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  28. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  29. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  30. 2021-11-23
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  31. 2021-12-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-01-26
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-15Moderna
22021-02-23Moderna
32021-10-26Moderna No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Cold sore

2021-01-18

Systemic reaction (other): Cold sore and slight allergic reaction,swollen bottom lip, 2nd day in a row. Took allergy meds.

2021-01-21

Systemic reaction (other): Painful eye and bruise on stomach, not sure if they are related.

Release 2 — day 7, dose 1

2021-01-22

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

2021-03-09

Symptoms: Sores in my mouth.

Release 5 — day 21, dose 2

2021-03-16

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

FieldPreferred term2021-092023-042024-11
SDPhotopsia ✓ ✓ ✓
SDStomatitis ✓ ✓ ✓
SROAbdominal discomfort ✓ ✓ ○
SROContusion ✓ ✓ ✓
SROEye injury · · ✓
SROEye pain ✓ ✓ ✓
SROHypersensitivity ✓ ✓ ✓
SROOcular hyperaemia ✓ ✓ ✓
SROOral discomfort ✓ ✓ ✓
SROOral herpes ✓ ✓ ✓
SROPhotophobia ✓ ✓ ✓
SROPre-existing disease · · ✓

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