3X6-41947-51068

3 vaccinations 11 coded responses 38 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 601 / IL
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Survey response — day 0, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-17
Dose 2 — Moderna
2021-03-17
Survey response — day 0, dose 2
MedDRA: Deafness, Vision blurred — Feeling: Fair · Site: Pain

Free text: L ear diminished hearing (received vaccine in L arm) and blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Oropharyngeal pain, Syncope — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Fainted, sore throat, loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Bronchospasm, Cough — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Bronchospasm and cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Bronchospasm — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Bronchospasm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Headache

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Good

Free text: Ive getting the headaches that I was getting right after the shot. They dont last long but are intense and not relieved by hydration or Tylenol.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Survey response — 3 months, dose 2
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-29
Dose 3 — Moderna
2022-01-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-01-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-02-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-02-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-02-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-04
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore Throat

MedDRA releases: 2024-11 · check-in free text available
2022-02-05
Survey response — day 7, dose 3
MedDRA: Dyspnoea exertional, Oropharyngeal pain, Productive cough — Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Productive Cough with fits, sore throat, SOB with exertion

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-02-19
Survey response — day 21, dose 3
MedDRA: Bronchospasm, Cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bronchospasm, cough

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-30
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-17	Moderna
3	2022-01-29	Moderna	No

Free text

Release 3 — day 0, dose 1

2021-02-03

Systemic reaction (other): Blurry vision

Release 5 — day 0, dose 2

2021-03-17

Systemic reaction (other): L ear diminished hearing (received vaccine in L arm) and blurry vision

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): Fainted, sore throat, loss of appetite

2021-03-19

Systemic reaction (other): Bronchospasm and cough

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Bronchospasm

2021-03-22

Systemic reaction (other): Tinnitus

Release 7 — day 28, dose 2

2021-04-14

Symptoms: Ive getting the headaches that I was getting right after the shot. They dont last long but are intense and not relieved by hydration or Tylenol.

Release 9 — 3 months, dose 2

2021-06-16

Symptoms: Headache

Release 11 — days 1–6 daily, dose 3

2022-02-04

Systemic reaction (other): Sore Throat

Release 11 — day 7, dose 3

2022-02-05

Systemic reaction (other): Productive Cough with fits, sore throat, SOB with exertion

Release 11 — day 21, dose 3

2022-02-19

Symptoms: Bronchospasm, cough

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	Bronchospasm	·	·	✓
SD	Cough	·	·	✓
SD	Headache	✓	✓	✓
SRO	Bronchospasm	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Deafness	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dyspnoea exertional	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Productive cough	·	·	✓
SRO	Syncope	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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