6DX-82909-22427

2 vaccinations 12 coded responses 24 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 462 / IN
Registered: 2021-03-17

Relationship: Self
Race: Black or African American
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

2021-03-16
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased, Ocular discomfort, Respiratory tract congestion — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Fast heart rate pressure around my eyes congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Fast heart beats at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Fatigue, Photophobia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Mild chest pain fatigue light pain in eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Balance disorder, Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Lightheaded slightly unbalance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Chest pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Mild chest pain back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Survey response — day 14, dose 1
MedDRA: Headache, Parosmia, Self-medication, Taste disorder — Feeling: Fair

Free text: My taste is off and that smokey smell is very strong and stays with me all day took tylenol for my consistent headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 21, dose 1
MedDRA: Cough, Dizziness, Head discomfort, Headache — Feeling: Fair

Free text: Constant headaches a little pressure a little cough lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Dose 2 — Moderna
2021-04-13
Survey response — day 0, dose 2
MedDRA: Vision blurred — Feeling: Good · Headache, Fatigue or tiredness

Free text: A little eye blurry

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: A little cramping pain in my chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Survey response — day 35, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Fair

Free text: Have breathing problems at times very fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-13	Moderna

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Fast heart rate pressure around my eyes congestion

2021-03-19

Systemic reaction (other): Fast heart beats at times

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Mild chest pain fatigue light pain in eyes

2021-03-21

Systemic reaction (other): Lightheaded slightly unbalance

2021-03-22

Systemic reaction (other): Mild chest pain back pain

Release 6 — day 14, dose 1

2021-03-30

Symptoms: My taste is off and that smokey smell is very strong and stays with me all day took tylenol for my consistent headache

Release 7 — day 21, dose 1

2021-04-06

Symptoms: Constant headaches a little pressure a little cough lightheaded

Release 7 — day 0, dose 2

2021-04-13

Systemic reaction (other): A little eye blurry

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Mild dry cough

2021-04-16

Systemic reaction (other): Congestion

2021-04-18

Systemic reaction (other): A little cramping pain in my chest

Release 8 — day 35, dose 2

2021-05-20

Symptoms: Have breathing problems at times very fatigued

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	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Parosmia	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Taste disorder	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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