6TN-28452-36782

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 070 / NJ
Registered: 2021-03-26

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

2021-03-25
Dose 1 — Moderna
2021-03-26
Registered in v-safe
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Good · Site: Pain · Headache

Free text: Blurry vision

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: Pain · 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 · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Dose 2 — Moderna
2021-04-22
Survey response — day 0, dose 2
MedDRA: Energy increased — Feeling: Good · Site: Pain

Free text: Makes me very energized. This happened the first time I got it to on the first day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: My toes are tingling. Feel unusual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Coughing, slight sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Pruritus, Rash — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: I have been noticing that my face is very itchy the last few days and today I have a rash on it it may not be Covid related but I thought I should report it. I am still very fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash on my face is still there but subsided

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Oral mucosal eruption, Rash — Feeling: Good · Fatigue or tiredness

Free text: Still have a rash slightly by my mouth on my face I am going to have it checked out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 7, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Still have rash on my face especially near my mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-22
Survey response — 12 months, dose 2
MedDRA: Cough, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: A severe sinus infection and coughing

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
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)
2022-04-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-26

Systemic reaction (other): Blurry vision

Release 7 — day 0, dose 2

2021-04-22

Systemic reaction (other): Makes me very energized. This happened the first time I got it to on the first day

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): No

2021-04-24

Systemic reaction (other): My toes are tingling. Feel unusual

2021-04-25

Systemic reaction (other): Coughing, slight sore throat

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): I have been noticing that my face is very itchy the last few days and today I have a rash on it it may not be Covid related but I thought I should report it. I am still very fatigued

2021-04-27

Systemic reaction (other): Rash on my face is still there but subsided

2021-04-28

Systemic reaction (other): Still have a rash slightly by my mouth on my face I am going to have it checked out

Release 8 — day 7, dose 2

2021-04-29

Systemic reaction (other): Still have rash on my face especially near my mouth

Release 11 — 12 months, dose 2

2022-04-22

Symptoms: A severe sinus infection and coughing

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	Sinusitis	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Energy increased	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oral mucosal eruption	✓	✓	○
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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