4AX-82908-52608

2 vaccinations 8 coded responses 14 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 770 / TX
Registered: 2021-05-01

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-20
Dose 1 — Moderna
2021-05-01
Registered in v-safe
2021-05-04
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pain in botton of my tummyand i still have hives Dr thot as offuce just prescribe prednisone for me i experience that sensation even with iut food

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Survey response — day 21, dose 1
MedDRA: Food allergy, Office visit, Pre-existing disease, Urticaria — Feeling: Good · Be unable to do your normal daily activities

Free text: I still have allergy hives to food specially eggs which i was never allergicc. I taking prednisone precribe att Dr (b)(6) the dr prescribe it for 7 days 1 aday to help me because i exceed the benadri

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Dose 2 — Moderna
2021-05-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Na

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Itching · Joint pains

Free text: Na

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains

Adult check-in
2021-05-22
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-28
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-04
Survey response — day 21, dose 2
MedDRA: Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Wheesing pain on my side leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-13
Survey response — day 28, dose 2
MedDRA: Back pain, Dizziness, Dyspnoea, Wheezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: i have short breath alot pain on my back and wheesingligth head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-13
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Food allergy, Inflammation, Malaise, Office visit, Throat tightness — Feeling: Poor · 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: Symptoms: Allergy's to foods anything my face imflamatiom my trhoat close difficult breathing · Healthcare visit (other): Am here today at dr thotas office am sick all this happens to me after i got moderna i ha e noit insurace and am sick

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Call 1 — Left Voicemail
2021-11-12
Survey response — 6 months, dose 2
MedDRA: Food allergy, Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have devolep allergy to several foods feel my rigth leg numb

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-20	Moderna
2	2021-05-14	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 8 — day 14, dose 1

2021-05-04

Symptoms: Pain in botton of my tummyand i still have hives Dr thot as offuce just prescribe prednisone for me i experience that sensation even with iut food

Release 8 — day 21, dose 1

2021-05-11

Symptoms: I still have allergy hives to food specially eggs which i was never allergicc. I taking prednisone precribe att Dr (b)(6) the dr prescribe it for 7 days 1 aday to help me because i exceed the benadri

redacted (b)(6)

Release 8 — days 1–6 daily, dose 2

2021-05-15

Systemic reaction (other): Na

2021-05-17

Systemic reaction (other): Na

Release 8 — day 21, dose 2

2021-06-04

Symptoms: Wheesing pain on my side leg

Release 9 — day 28, dose 2

2021-06-13

Symptoms: i have short breath alot pain on my back and wheesingligth head

Release 9 — 3 months, dose 2

2021-08-13

Symptoms: Allergy's to foods anything my face imflamatiom my trhoat close difficult breathing

Healthcare visit (other): Am here today at dr thotas office am sick all this happens to me after i got moderna i ha e noit insurace and am sick

Release 10 — 6 months, dose 2

2021-11-12

Symptoms: I have devolep allergy to several foods feel my rigth leg numb

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	Malaise	✓	·	✓
HCVO	Office visit	✓	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Food allergy	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Inflammation	✓	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	✓	·	○
SD	Throat tightness	✓	·	✓
SD	Urticaria	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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