3XW-28284-97712

4 vaccinations 7 coded responses 46 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 951 / CA
Registered: 2021-04-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-05
Registered in v-safe
2021-04-05
Dose 1 — Moderna
2021-04-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Chills, Headache, Fatigue or tiredness

Free text: Symptoms appeared actually yesterday night, about 48hs after the shoot. It lasted for 3 hours, I'm feeling better today.

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

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-03
Dose 2 — Moderna
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Blepharospasm — Feeling: Good

Free text: Right Eye started to twitch the day after the vaccine. Not sure if it's related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — day 7, dose 2
MedDRA: Blepharospasm — Feeling: Good

Free text: Eye twitch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-31
Survey response — day 28, dose 2
MedDRA: Joint swelling, Limb discomfort, Peripheral swelling, Tenderness — Feeling: Good

Free text: Swollen legs from the knees down sensitive and heavy. Never have that before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 3 months, dose 2
MedDRA: Hypoaesthesia — Feeling: Good

Free text: Arms numbness when waking up

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-06
Dose 3 — Moderna
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-14
Dose 4 — Moderna
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-21
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-27
Survey response — day 42, dose 4
MedDRA: Tinnitus, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Tinnitus. Actually started 1 week after shot, it got worse with time. I never had that before, it appeared out of the blue. Somehow i have not reported before. · Healthcare visit (other): Set up an appointment to see doctor

MedDRA releases: 2024-11 · check-in free text available
2022-06-27
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-28
Call 2 — Left Voicemail
2023-05-15
Survey response — 12 months, dose 4
MedDRA: Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-05-15
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-16
Call 1 — Left Voicemail
2023-05-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Moderna
2	2021-05-03	Moderna
3	2021-12-06	Moderna	No
4	2022-05-14	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-08

Systemic reaction (other): Symptoms appeared actually yesterday night, about 48hs after the shoot. It lasted for 3 hours, I'm feeling better today.

Release 8 — days 1–6 daily, dose 2

2021-05-09

Systemic reaction (other): Right Eye started to twitch the day after the vaccine. Not sure if it's related

Release 8 — day 7, dose 2

2021-05-10

Systemic reaction (other): Eye twitch

Release 8 — day 28, dose 2

2021-05-31

Symptoms: Swollen legs from the knees down sensitive and heavy. Never have that before.

Release 9 — 3 months, dose 2

2021-08-02

Symptoms: Arms numbness when waking up

Release 12 — day 42, dose 4

2022-06-27

Symptoms: Tinnitus. Actually started 1 week after shot, it got worse with time. I never had that before, it appeared out of the blue. Somehow i have not reported before.

Healthcare visit (other): Set up an appointment to see doctor

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
HCVO	Unevaluable event	·	·	✓
SD	Hypoaesthesia	✓	·	✓
SD	Joint swelling	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Tenderness	✓	✓	✓
SD	Tinnitus	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Blepharospasm	✓	✓	✓

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