5J2-23131-39917

2 vaccinations 9 coded responses 12 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 783 / TX
Registered: 2021-05-13

Relationship: Self
Race: Other
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

2021-04-28
Dose 1 — Moderna
2021-05-13
Registered in v-safe
2021-05-13
Survey response — day 14, dose 1
MedDRA: Arthralgia, Diarrhoea, Fatigue, Headache, Lip swelling, Myalgia, Vision blurred — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Day 1 - Extremely tired, Day 2 Diarrhea, day3 blurred vision, from day 4 to present extreme fatigue with generalized joint & Muscle Aches. 5/9 to present lip swelling with big blister on left side of upper lip with headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 21, dose 1
MedDRA: Dizziness, Headache, Herpes zoster, Myalgia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: The shingles breakout now moved to the lower lip. Still having weekends, muscle aches, lightheaded, and headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Dose 2 — Moderna
2021-05-29
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: rash sites have been swelling in size arms/back/buttocks area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: The rash has gotten smaller compared to yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-06-02
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-06-09
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and muscle aches still at moderate levels, and now with headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Survey response — day 21, dose 2
MedDRA: Herpes zoster, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: another shingles outbreak on the opposite side of the lip along with body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Survey response — day 28, dose 2
MedDRA: Constipation, Herpes zoster, Muscle spasms, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Constapation, and still having muscle aches and cramps, along with shingles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-07
Survey response — day 42, dose 2
MedDRA: Bone pain, Hypothyroidism, Myalgia, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle and bone pains keep increasing in intensity. Not sure if the extremely low thyroid level has anything to due with vaccinations, but will discuss with provider after giving the medication time to correct the levels.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-25
Survey response — 3 months, dose 2
MedDRA: Fatigue, Headache, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely fatigued, headaches, and body aches

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-28	Moderna
2	2021-05-26	Moderna

Free text

Release 8 — day 14, dose 1

2021-05-13

Symptoms: Day 1 - Extremely tired, Day 2 Diarrhea, day3 blurred vision, from day 4 to present extreme fatigue with generalized joint & Muscle Aches. 5/9 to present lip swelling with big blister on left side of upper lip with headache.

Release 8 — day 21, dose 1

2021-05-21

Symptoms: The shingles breakout now moved to the lower lip. Still having weekends, muscle aches, lightheaded, and headaches

Release 8 — days 1–6 daily, dose 2

2021-05-29

Systemic reaction (other): rash sites have been swelling in size arms/back/buttocks area

2021-05-30

Systemic reaction (other): The rash has gotten smaller compared to yesterday

Release 9 — day 14, dose 2

2021-06-09

Symptoms: Fatigue and muscle aches still at moderate levels, and now with headaches

Release 9 — day 21, dose 2

2021-06-18

Symptoms: another shingles outbreak on the opposite side of the lip along with body aches

Release 9 — day 28, dose 2

2021-06-25

Symptoms: Constapation, and still having muscle aches and cramps, along with shingles

Release 9 — day 42, dose 2

2021-07-07

Symptoms: Muscle and bone pains keep increasing in intensity. Not sure if the extremely low thyroid level has anything to due with vaccinations, but will discuss with provider after giving the medication time to correct the levels.

Release 9 — 3 months, dose 2

2021-08-25

Symptoms: Extremely fatigued, headaches, and body aches

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	Arthralgia	✓	✓	✓
SD	Bone pain	✓	✓	✓
SD	Constipation	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Hypothyroidism	✓	✓	✓
SD	Lip swelling	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Swelling	✓	✓	✓

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