4C6-16253-20144

3 vaccinations 6 coded responses 15 check-ins 6 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 922 / CA
Registered: 2021-11-12

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

2021-01-12
Dose 1 — Moderna
2021-02-12
Dose 2 — Moderna
2021-11-12
Registered in v-safe
2021-11-12
Dose 3 — Moderna
2021-11-12
Survey response — day 0, dose 3
MedDRA: Vision blurred — Feeling: Poor · Site: Pain · Headache · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain, Diarrhoea, Reaction to previous exposure to any vaccine — Feeling: Good · Site: Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Yes.. i have moderate diarrhea with abo pain... It is hard to explain on a text... my very 1st Moderna Vaccine was horrible..my 2nd vaccine was mild headaches..but my booster vaccine was almost like my 1st vaccine...

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Office visit, Pre-existing disease, Tinnitus — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Ears ringing from the 1st vaccine.. intensivefied by booster.. eye appointment 11/17 and Pcp appointment 11/20 · Healthcare visit (other): Eye doctor

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Office visit, Tinnitus, Vision blurred — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Ringing in ears · Healthcare visit (other): Eye doctor for blurred vision

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-16
Call 2 — Left Voicemail
2021-11-17
Survey response — days 1–6 daily, dose 3
MedDRA: Office visit — Feeling: Good · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Eye doctor

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-17
Call 2 — Could Not Reach Participant
2021-11-18
Call 3 — Could Not Reach Participant
2021-11-19
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-11-19
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-26
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-29
Call 2 — Could Not Reach Participant
2021-12-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-06
Call 3 — Could Not Reach Participant
2021-12-12
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-19
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-25
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-13
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-12
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Covid June 5, 2022

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-11-14
Call 1 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2022-11-14
Call successful
Not applicable - Accidental Reporting
2022-11-14
Call successful
Not applicable - Accidental Reporting
2022-11-14
Call successful
Not applicable - Accidental Reporting
2022-11-14
Call successful
Not applicable - Accidental Reporting
2022-11-14
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna	No
2	2021-02-12	Moderna	No
3	2021-11-12	Moderna	No

Call center

5 call center cases

5 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 10 — day 0, dose 3

2021-11-12

Systemic reaction (other): Blurred vision

Release 10 — days 1–6 daily, dose 3

2021-11-14

Systemic reaction (other): Yes.. i have moderate diarrhea with abo pain... It is hard to explain on a text... my very 1st Moderna Vaccine was horrible..my 2nd vaccine was mild headaches..but my booster vaccine was almost like my 1st vaccine...

2021-11-15

Systemic reaction (other): Ears ringing from the 1st vaccine.. intensivefied by booster.. eye appointment 11/17 and Pcp appointment 11/20

Healthcare visit (other): Eye doctor

2021-11-16

Systemic reaction (other): Ringing in ears

Healthcare visit (other): Eye doctor for blurred vision

2021-11-17

Healthcare visit (other): Eye doctor

Release 12 — 12 months, dose 3

2022-11-12

Symptoms: Covid June 5, 2022

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	Office visit	·	·	✓
HCVO	Vision blurred	·	·	✓
SD	COVID-19	·	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Tinnitus	·	·	✓
SRO	Vision blurred	·	·	✓

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