453-33909-16037

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 843 / UT
Registered: 2021-03-09

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-09
Health check-in — day 0, dose 1
Feeling: Fair · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Pulmonary pain, Throat irritation — Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Itchy throat and lung pain that may or may not be related to the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Constipation, Flatulence — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Free text: Abdominal pain is gas and constipation which is more likely due to medication and diet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Insomnia, Throat irritation — Feeling: Fair · Site: Pain · Abdominal pain · Be unable to work

Free text: Insomnia. Shortness of breath and itchy throat. Probably unrelated to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea, Abdominal pain

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good · Chills, Abdominal pain

Free text: I don't think either of those are vaccine-related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-06
Survey response — day 0, dose 2
MedDRA: Flatulence, Insomnia — Feeling: Fair · Fatigue or tiredness

Free text: Insomnia and awful gas over the last week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Acne — Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Acne increased after both shots, but first one wasn't permanent and I don't expect the second to be, either.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Chills, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, dose 2
MedDRA: Emergency care, Gingival recession, Oral mucosal exfoliation — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Not sure if related to vaccine, but sudden problems with my gums peeling and coming unattached. Due to nowhere being open and possibility of medication or vaccine reaction, went to ER. They did nothing and said see the dentist, which I cannot afford.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 28, dose 2
MedDRA: Emergency care, Gingival recession, Oral mucosal exfoliation, Vitreous floaters — Feeling: Good

Free text: Good except, gums are receding and peeling suddenly. I see a new floater in my eye. I did go to the ER just to be sure it wasn't mediation or vaccine related. I was told to see dental and eye specialists I may have trouble affording and scheduling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 35, dose 2
MedDRA: Gingival disorder, Gingival recession — Feeling: Fair

Free text: Gum problems, gum recession, especially bottom front teeth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 42, dose 2
Feeling: Poor

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-06
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Itchy throat and lung pain that may or may not be related to the shot.

2021-03-11

Systemic reaction (other): Abdominal pain is gas and constipation which is more likely due to medication and diet.

2021-03-12

Systemic reaction (other): Insomnia. Shortness of breath and itchy throat. Probably unrelated to vaccine.

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): I don't think either of those are vaccine-related.

Release 7 — day 0, dose 2

2021-04-06

Systemic reaction (other): Insomnia and awful gas over the last week.

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Acne increased after both shots, but first one wasn't permanent and I don't expect the second to be, either.

Release 8 — day 21, dose 2

2021-04-27

Symptoms: Not sure if related to vaccine, but sudden problems with my gums peeling and coming unattached. Due to nowhere being open and possibility of medication or vaccine reaction, went to ER. They did nothing and said see the dentist, which I cannot afford. cut off by CDC

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Good except, gums are receding and peeling suddenly. I see a new floater in my eye. I did go to the ER just to be sure it wasn't mediation or vaccine related. I was told to see dental and eye specialists I may have trouble affording and scheduling. cut off by CDC

Release 8 — day 35, dose 2

2021-05-13

Symptoms: Gum problems, gum recession, especially bottom front teeth.

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	Emergency care	✓	✓	✓
SD	Gingival disorder	✓	✓	✓
SD	Gingival recession	✓	✓	✓
SD	Oral mucosal exfoliation	✓	✓	✓
SD	Vitreous floaters	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Acne	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Pulmonary pain	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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