4FC-11014-12720
2 vaccinations
3 coded responses
23 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 406 / KY
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-23
Dose 1 — Moderna
-
2021-02-26
Registered in v-safe
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-09
- 2021-03-16
-
2021-03-23
Dose 2 — Moderna
- 2021-03-23
-
2021-03-24
Survey response — days 1–6 daily, dose 2MedDRA: Contusion — Feeling: Good · Site: Pain · HeadacheFree text: My left I feels bruised and just above it. Happened last month too but I didnt link it to the vaccine. It is very weird.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-25
Survey response — days 1–6 daily, dose 2MedDRA: Eye disorder, Fatigue, Injection site pain — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Same eye problem as yesterday. Today pain underarm besides at injection site. Also after I answered yesterdays questions, I got extremely fatigued so that isnt on record.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-26
Survey response — days 1–6 daily, dose 2MedDRA: Contusion, Eye pain, Headache, Tenderness — Feeling: Fair · HeadacheFree text: On the side I got my shot, my side is tender - doesnt hurt til I touch it. Realized this last night. Eye still feels bruised and the pain near it is in the brow area. Read some headaches are like that so decided this was a very concentrated headache that was really bad today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-22
- 2021-04-27
- 2021-05-05
- 2021-06-22
- 2021-09-21
- 2022-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-23 | Moderna | |
| 2 | 2021-03-23 | Moderna |
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): My left I feels bruised and just above it. Happened last month too but I didnt link it to the vaccine. It is very weird.
Systemic reaction (other): Same eye problem as yesterday. Today pain underarm besides at injection site. Also after I answered yesterdays questions, I got extremely fatigued so that isnt on record.
Systemic reaction (other): On the side I got my shot, my side is tender - doesnt hurt til I touch it. Realized this last night. Eye still feels bruised and the pain near it is in the brow area. Read some headaches are like that so decided this was a very concentrated headache that was really bad today.
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 | Contusion | ✓ | ✓ | ✓ |
| SRO | Eye disorder | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release