48A-29617-08286

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 982 / WA
Registered: 2021-04-17

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

2021-04-15
Dose 1 — Moderna
2021-04-17
Registered in v-safe
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Injection site pain — Feeling: Good

Free text: A mild headache the first three days, very mild pain at injection site. Nothing now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-12
Dose 2 — Moderna
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Electric shock sensation, Immediate post-injection reaction — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Free text: Had an immediate reaction to shot #2; I didnt have any shock reaction with the first shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Arthralgia, Chest discomfort, Decreased appetite, Fatigue, Musculoskeletal chest pain, Myalgia, Nausea, Taste disorder — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: All joint and muscle pain is gone today except uncomfortably sharp rib pain just under left breast and a bit under the right breast. This particular was not there until after the vaccine shot.Taste buds are not as off as yesterday, but appetite is nil and nausea is uncomfortable though not vomiting; hammering stomach. A lot of air in my chestuncomfortable. Easily tired but I feel stronger today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Dissociation, Fatigue, Immediate post-injection reaction, Impaired driving ability, Pre-existing disease, Self-medication, Tension headache, Vertigo, Vomiting — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: Mild vertigo. Almost immediately after this second injection I felt vertigoI called it a shock reaction earlier. I havent driven a car for days because of it. Mild but not safe as a driverI dont feel fully connected to my surroundings. The fatigue and pressure headaches continue but are less each day. Using Advil now. Still eating soft foods; vomiting first day was very hard on my stomach, which is susceptible to acid reflux.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Gastrooesophageal reflux disease, Malaise, Vomiting — Feeling: Good

Free text: Acid reflux was caused by the vomiting from being severely ill for 36 hours after #2 Moderna injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 7, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: All these symptoms are due to acid reflux. I got sick from the vaccine and have had acid reflux for a week now. I confused it with the vaccine to begin with. I was worried. Now I know the vaccine is safe; but it will take weeks to calm the reflux.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-12	Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-19

Systemic reaction (other): A mild headache the first three days, very mild pain at injection site. Nothing now.

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Had an immediate reaction to shot #2; I didnt have any shock reaction with the first shot.

2021-05-15

Systemic reaction (other): All joint and muscle pain is gone today except uncomfortably sharp rib pain just under left breast and a bit under the right breast. This particular was not there until after the vaccine shot.Taste buds are not as off as yesterday, but appetite is nil and nausea is uncomfortable though not vomiting; hammering stomach. A lot of air in my chestuncomfortable. Easily tired but I feel stronger today.

2021-05-17

Systemic reaction (other): Mild vertigo. Almost immediately after this second injection I felt vertigoI called it a shock reaction earlier. I havent driven a car for days because of it. Mild but not safe as a driverI dont feel fully connected to my surroundings. The fatigue and pressure headaches continue but are less each day. Using Advil now. Still eating soft foods; vomiting first day was very hard on my stomach, which is susceptible to acid reflux.

2021-05-18

Systemic reaction (other): Acid reflux was caused by the vomiting from being severely ill for 36 hours after #2 Moderna injection.

Release 8 — day 7, dose 2

2021-05-19

Systemic reaction (other): All these symptoms are due to acid reflux. I got sick from the vaccine and have had acid reflux for a week now. I confused it with the vaccine to begin with. I was worried. Now I know the vaccine is safe; but it will take weeks to calm the reflux.

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
SRO	Abdominal discomfort	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dissociation	✓	✓	✓
SRO	Electric shock sensation	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Impaired driving ability	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Tension headache	✓	✓	✓
SRO	Vertigo	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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