48A-13189-63490

2 vaccinations 13 coded responses 19 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 105 / NY
Registered: 2021-09-28

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-09-27
Dose 1 — Moderna
2021-09-28
Registered in v-safe
2021-09-28
Survey response — days 1–6 daily, dose 1
MedDRA: Eye swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Swollen eye

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-10-02
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Some chest pain- last few days (mild)

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-11
Survey response — day 14, dose 1
MedDRA: Eye pain, Headache, Muscle spasms, Ocular discomfort — Feeling: Fair

Free text: eye pain (pressure behind the eye), sharp muscles spasm in my legs, headache (still)

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-10-25
Dose 2 — Moderna
2021-10-25
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness, Eye pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizzy, pain in left eye, brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness, Eye pain, Sneezing — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizzy, brain fog, left eye pain, sneezing

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizzy, brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — day 14, dose 2
MedDRA: Chills, Cough, Diarrhoea, Nasal congestion, Nausea, Oropharyngeal pain, Rash — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, cough, stuffy nose, chills, nauseous, diarrhea, rash

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper, Dizziness, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Dizzy, headache, nauseous, stomach pains

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-17
Call 1 — Left Voicemail
2021-12-12
Survey response — day 42, dose 2
MedDRA: Neuralgia, Pain, Skin tightness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Weird shooting nerve pain up and down my arm and leg. Feels tight and sharp. More prominent around my join areas. Never had this prior to the vaccine. Plan on seeing a dr if this presides.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-27	Moderna	No
2	2021-10-25	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-28

Systemic reaction (other): Swollen eye

2021-09-30

Systemic reaction (other): Dizzy

2021-10-02

Systemic reaction (other): Some chest pain- last few days (mild)

Release 10 — day 14, dose 1

2021-10-11

Symptoms: eye pain (pressure behind the eye), sharp muscles spasm in my legs, headache (still)

Release 10 — day 0, dose 2

2021-10-25

Systemic reaction (other): Dizzy

Release 10 — days 1–6 daily, dose 2

2021-10-26

Systemic reaction (other): Dizzy, pain in left eye, brain fog

2021-10-27

Systemic reaction (other): Dizzy, brain fog, left eye pain, sneezing

2021-10-28

Systemic reaction (other): Dizzy, brain fog

2021-10-31

Systemic reaction (other): Dizzy

Release 10 — day 7, dose 2

2021-11-01

Systemic reaction (other): Dizzy

Release 10 — day 14, dose 2

2021-11-08

Symptoms: Sore throat, cough, stuffy nose, chills, nauseous, diarrhea, rash

Release 10 — day 21, dose 2

2021-11-15

Symptoms: Dizzy, headache, nauseous, stomach pains

Release 10 — day 42, dose 2

2021-12-12

Symptoms: Weird shooting nerve pain up and down my arm and leg. Feels tight and sharp. More prominent around my join areas. Never had this prior to the vaccine. Plan on seeing a dr if this presides.

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	Abdominal pain upper	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Eye pain	·	·	✓
SD	Headache	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	·	·	✓
SD	Neuralgia	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Rash	·	·	✓
SD	Skin tightness	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Eye pain	·	·	✓
SRO	Eye swelling	·	·	✓
SRO	Sneezing	·	·	✓

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