4XL-29388-52361

2 vaccinations 15 coded responses 23 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 109 / NY
Registered: 2021-03-06

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

2021-03-04
Dose 1 — Moderna
2021-03-06
Registered in v-safe
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Defaecation urgency, Diarrhoea, Dizziness, Dyspnoea, Respiratory tract congestion — Feeling: Poor · Nausea · Be unable to do your normal daily activities

Free text: Dizziness, congestion, breathlessness, not diarrhea but loose stools and urgency

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Headache

Free text: Mildly sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 7, dose 1
MedDRA: Aphthous ulcer, Ear pain, Lymphadenopathy, Toothache — Feeling: Fair · Headache

Free text: Swollen glands in neck, canker sore in back right corner of mouth, ear pain and tooth pain on the right side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 21, dose 1
MedDRA: Migraine, Muscle spasms, Swelling — Feeling: Poor

Free text: Migraines, swelling, leg cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Dose 2 — Moderna
2021-04-01
Survey response — day 0, dose 2
MedDRA: Peripheral coldness, Stomatitis, Throat irritation — Feeling: Good · Site: Pain

Free text: Cold hands, mouth/throat feels a little weird

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Glossodynia, Insomnia, Middle insomnia, Oral pain, Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: My mouth, tongue and throat are sore. Also, I was awake most of the night. I am having trouble sleeping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: A bruise on my leg. As the day goes on I feel better and better

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

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Sleeplessness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia, Pruritus, Somnolence, Urticaria — Feeling: Good · Site: Pain, Itching

Free text: Sleeplessness, tingly skin and itchy hives

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Urticaria — Feeling: Fair · Nausea, Diarrhea · Be unable to work

Free text: Itching and hives in random places

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 7, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Survey response — day 21, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 28, dose 2
MedDRA: Diarrhoea, Food intolerance — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Recurring food senditivity and diarrhea. I am managing with Creon and probiotics

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Cough, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I cough a lot more than I used to sometimes when I am eating. My adhd is worse.

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-04
Call 1 — Left Voicemail
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Gastrooesophageal reflux disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Acid reflux. · Healthcare visit (other): Endoscopy

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): Dizziness, congestion, breathlessness, not diarrhea but loose stools and urgency

2021-03-09

Systemic reaction (other): Mildly sore throat

Release 5 — day 7, dose 1

2021-03-11

Systemic reaction (other): Swollen glands in neck, canker sore in back right corner of mouth, ear pain and tooth pain on the right side

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Migraines, swelling, leg cramps

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): Cold hands, mouth/throat feels a little weird

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): My mouth, tongue and throat are sore. Also, I was awake most of the night. I am having trouble sleeping

2021-04-03

Systemic reaction (other): A bruise on my leg. As the day goes on I feel better and better

2021-04-05

Systemic reaction (other): Sleeplessness.

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Sleeplessness, tingly skin and itchy hives

2021-04-07

Systemic reaction (other): Itching and hives in random places

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Itching

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Diarrhea

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Recurring food senditivity and diarrhea. I am managing with Creon and probiotics

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: I cough a lot more than I used to sometimes when I am eating. My adhd is worse.

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Acid reflux.

Healthcare visit (other): Endoscopy

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	Unevaluable event	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Food intolerance	✓	✓	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Migraine	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Swelling	✓	✓	✓
SRO	Aphthous ulcer	✓	✓	✓
SRO	Contusion	✓	✓	✓
SRO	Defaecation urgency	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Glossodynia	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Oral pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Stomatitis	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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