56A-12171-58371

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 917 / CA
Registered: 2021-03-24

Relationship: Self
Race: Asian
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

2021-03-23
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Palpitations — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: On and off dizziness and experienced palpitations twice while at work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Terminal insomnia — Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness, Abdominal pain

Free text: Severe headache woke me up 4:45am. Not my usual headache. It lasted for 5 minutes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 21, dose 1
MedDRA: Contusion — Feeling: Good

Free text: Bruises on left thigh, left bicep, right forearm. They just appeared one at a time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Dose 2 — Moderna
2021-04-20
Survey response — day 0, dose 2
MedDRA: Dizziness, Dyspnoea, Flushing, Hypoaesthesia oral, Immediate post-injection reaction — Feeling: Good · Site: Pain · Headache

Free text: Numbness of tongue and lips 5 mins after the shot lasted couple hours, minor face flushing 15 mins after the shot and slight dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: Shortness of breath when physically active/ walking fast

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Abdominal pain

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good

Free text: Shortness of breath when doing physical activity or walking/ moving fast at work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-23
Survey response — 3 months, dose 2
MedDRA: Asthenia, Dyspnoea — Feeling: Fair

Free text: There were times that i feel weak while walking and my breathing is not as good as before.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-23
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Moderna
2	2021-04-20	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): On and off dizziness and experienced palpitations twice while at work

2021-03-26

Systemic reaction (other): Severe headache woke me up 4:45am. Not my usual headache. It lasted for 5 minutes

Release 7 — day 21, dose 1

2021-04-13

Symptoms: Bruises on left thigh, left bicep, right forearm. They just appeared one at a time.

Release 7 — day 0, dose 2

2021-04-20

Systemic reaction (other): Numbness of tongue and lips 5 mins after the shot lasted couple hours, minor face flushing 15 mins after the shot and slight dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-21

Systemic reaction (other): Dizziness

2021-04-22

Systemic reaction (other): Shortness of breath when physically active/ walking fast

2021-04-24

Systemic reaction (other): Shortness of breath when doing physical activity or walking/ moving fast at work

Release 9 — 3 months, dose 2

2021-07-23

Symptoms: There were times that i feel weak while walking and my breathing is not as good as before.

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	Asthenia	✓	·	✓
SD	Contusion	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Terminal insomnia	✓	✓	✓

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