4XT-30665-98005

2 vaccinations 11 coded responses 15 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 912 / CA
Registered: 2021-01-02

Relationship: Self
Race: Other
Ethnicity: 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

2021-01-02
Registered in v-safe
2021-01-02
Dose 1 — Moderna
2021-01-02
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Chills

Free text: None thankfully

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Throat irritation — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Slight Scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Eye irritation, Pre-existing disease, Self-medication, Vision blurred — Feeling: Fair · Site: Pain

Free text: My right eye was irritated felt like sand in eye , eye not red. Had Lasik about 10 years ago I can see ok in morning was a little blurry . I put visine Drops and it is helping .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Wheezing — Feeling: Good · Fatigue or tiredness

Free text: Yesterday wheeze took inhaler and sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms, Myalgia — Feeling: Good · Fatigue or tiredness

Free text: Left bicep was jerking a little for a few days right after the vaccine. Thought it might be due to soreness?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Survey response — day 7, dose 1
MedDRA: Diarrhoea, Impaired work ability, Muscle spasms — Feeling: Good · Diarrhea

Free text: I almost had to go home from work but it symptoms slowed down after a few hours yesterday. Diarrhea was yesterday 3-4 loose stool and this early morning cramping and loose stool x 1 No further after that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-30
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-13
Survey response — day 7, dose 2
MedDRA: Diarrhoea, Fatigue, Headache, Neck pain, Respiratory tract congestion — Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: Neck pain for about 1/2 day on/off sharp pain then resolved; Very tired . Diarrhea a week after dosing just like when u received my first dose in January. Mild to moderate fatigue I wasnt able to work on Saturday a week from the shot for one say. Slight headache and Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — day 14, dose 2
MedDRA: Diarrhoea, Rhinorrhoea, Sensitivity to weather change — Feeling: Good

Free text: Just sniffles but weather has been windy and cold . Better today after one day of sniffles yesterday Saturday loose stool x3 resolved after that .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 21, dose 2
MedDRA: Cough, Fatigue, Nasal congestion, Pre-existing disease, Sneezing — Feeling: Fair

Free text: Its been windy and I have a history of allergies and asthma So I have been having some nasal congestion that clears in the day on and off , sneezing, cough on off clears w inhaler .A little fatigue Thank you

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 28, dose 2
MedDRA: Asthma, Condition aggravated, Cough, Eye irritation, Eye pruritus, Hypersensitivity, Nasal congestion, Pre-existing disease, Seasonal allergy, Sneezing — Feeling: Fair

Free text: Its been windy but I have Stuffy nose sneezing, eye it ch big irritation worsening in the evenings, slight on and off cough I have a history of seasonal allergies and asthma mild But eyes are not pink just very itchy Better today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-09
Survey response — 6 months, dose 2
MedDRA: Eye pruritus, Oropharyngeal pain — Feeling: Fair

Free text: Minor sore throat snd eye itching on Saturday eye is ok and throat better

MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-02-01	Moderna

Free text

Release 1 — day 0, dose 1

2021-01-02

Systemic reaction (other): None thankfully

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Slight Scratchy throat

2021-01-04

Systemic reaction (other): My right eye was irritated felt like sand in eye , eye not red. Had Lasik about 10 years ago I can see ok in morning was a little blurry . I put visine Drops and it is helping .

2021-01-07

Systemic reaction (other): Yesterday wheeze took inhaler and sore throat

2021-01-08

Systemic reaction (other): Left bicep was jerking a little for a few days right after the vaccine. Thought it might be due to soreness?

Release 1 — day 7, dose 1

2021-01-10

Systemic reaction (other): I almost had to go home from work but it symptoms slowed down after a few hours yesterday. Diarrhea was yesterday 3-4 loose stool and this early morning cramping and loose stool x 1 No further after that.

Release 4 — day 7, dose 2

2021-02-13

Systemic reaction (other): Neck pain for about 1/2 day on/off sharp pain then resolved; Very tired . Diarrhea a week after dosing just like when u received my first dose in January. Mild to moderate fatigue I wasnt able to work on Saturday a week from the shot for one say. Slight headache and Congestion

Release 4 — day 14, dose 2

2021-02-15

Symptoms: Just sniffles but weather has been windy and cold . Better today after one day of sniffles yesterday Saturday loose stool x3 resolved after that .

Release 4 — day 21, dose 2

2021-02-22

Symptoms: Its been windy and I have a history of allergies and asthma So I have been having some nasal congestion that clears in the day on and off , sneezing, cough on off clears w inhaler .A little fatigue Thank you

Release 4 — day 28, dose 2

2021-03-03

Symptoms: Its been windy but I have Stuffy nose sneezing, eye it ch big irritation worsening in the evenings, slight on and off cough I have a history of seasonal allergies and asthma mild But eyes are not pink just very itchy Better today

Release 9 — 6 months, dose 2

2021-08-09

Symptoms: Minor sore throat snd eye itching on Saturday eye is ok and throat better

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	Asthma	✓	✓	✓
SD	Condition aggravated	○	✓	○
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Eye irritation	✓	·	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypersensitivity	✓	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Seasonal allergy	○	✓	○
SD	Sensitivity to weather change	✓	✓	✓
SD	Sneezing	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Unevaluable event	○	○	○
SRO	Vision blurred	✓	✓	✓
SRO	Wheezing	✓	✓	✓

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