4PM-41368-79111

1 vaccination 9 coded responses 12 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 385 / TN
Registered: 2021-04-01

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

2021-03-31
Dose 1 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pain — Feeling: Good · Site: Pain

Free text: Left eye ache still

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Erythema, Feeling hot, Hypoaesthesia, Hypoaesthesia oral — Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activities

Free text: turned numb and then forehead. Started dizzy head chest and Arms. Had to pull over on highway for husband to finish driving. Then tongue numb and cheeks bright red and hot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Dizziness down through chest and arms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Hypoaesthesia, Hypoaesthesia oral, Skin warm — Feeling: Poor · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Numb nose, cheeks, forehead, lips, ears, tongue. Red and hot to touch cheeks and ears. Chest feeling weird.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Feeling hot, Hypoaesthesia, Hypoaesthesia oral, Nausea, Parosmia, Pruritus — Feeling: Good · Headache, Fatigue or tiredness, Nausea

Free text: Today red cheeks and hot. Itching in spots all over body. Yesterday afternoon had numb nose, lips, tongue forehead, chin. Nausea and kept smelling smoking ham. Had this for hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Bone pain, Cold sweat, Headache, Hypoaesthesia oral, Intranasal hypoaesthesia, Nausea, Sensory disturbance — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Al last night i felt all my bones hurting bad. Back arms neck legs. When i got up i started cold sweats. I had a numb nose, tongue and all around my mouth was numb. Have felt nausea and funny feeling in my head most if day with no energy. Had light headaches also.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Good · Headache, Fatigue or tiredness

Free text: No other today for first time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-09-29
Survey response — 6 months, dose 1
MedDRA: Dizziness, Ocular discomfort, Vision blurred, Visual impairment — Feeling: Good · Be unable to do your normal daily activities

Free text: Still having dizzy spells off and on. My eyes still blur some since my covid shot. Now have eyesight change and high eye pressures

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Survey response — 12 months, dose 1
MedDRA: Ageusia, Anosmia — Feeling: Good

Free text: Lost taste and smell.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-01

Systemic reaction (other): Left eye ache still

2021-04-02

Systemic reaction (other): turned numb and then forehead. Started dizzy head chest and Arms. Had to pull over on highway for husband to finish driving. Then tongue numb and cheeks bright red and hot.

2021-04-03

Systemic reaction (other): Dizziness down through chest and arms

2021-04-04

Systemic reaction (other): Numb nose, cheeks, forehead, lips, ears, tongue. Red and hot to touch cheeks and ears. Chest feeling weird.

2021-04-05

Systemic reaction (other): Today red cheeks and hot. Itching in spots all over body. Yesterday afternoon had numb nose, lips, tongue forehead, chin. Nausea and kept smelling smoking ham. Had this for hours.

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Al last night i felt all my bones hurting bad. Back arms neck legs. When i got up i started cold sweats. I had a numb nose, tongue and all around my mouth was numb. Have felt nausea and funny feeling in my head most if day with no energy. Had light headaches also.

Release 7 — day 7, dose 1

2021-04-07

Systemic reaction (other): No other today for first time.

Release 9 — 6 months, dose 1

2021-09-29

Symptoms: Still having dizzy spells off and on. My eyes still blur some since my covid shot. Now have eyesight change and high eye pressures

Release 11 — 12 months, dose 1

2022-03-31

Symptoms: Lost taste and smell.

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Dizziness	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Vision blurred	·	·	✓
SD	Visual impairment	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Bone pain	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Intranasal hypoaesthesia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sensory disturbance	✓	✓	✓
SRO	Skin warm	✓	✓	✓

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