Y85-88753-61955

2 vaccinations 12 coded responses 21 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 871 / NM
Registered: 2021-01-12

Relationship: Self
Race: American Indian or Alaska Native
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

2021-01-08
Dose 1 — Moderna
2021-01-12
Registered in v-safe
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain · Nausea

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Survey response — day 7, dose 1
MedDRA: Respiratory tract congestion — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Survey response — day 21, dose 1
MedDRA: Abnormal faeces, Decreased appetite, Nausea, Rash — Feeling: Fair

Free text: Digestion concerns. Not severe enough to see a health care provider, but very concerning to see abnormal feces. Other concerns involve a change in skin condition from clear to breakouts. Final concern is a lack of appetite and nausea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Dry eye, Nasal congestion — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, 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: Dehydrated. Dry eyes. Nasal congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Nasal congestion — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Nasal congestion. Dehydration.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Nasal congestion — Feeling: Fair · Site: Pain, Itching

Free text: Nasal congestion and dehydration.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Nasal congestion, Respiratory tract congestion — Feeling: Good · Site: Pain, Itching · Diarrhea, Rash, not including the immediate area around the injection site

Free text: Dehydration, nasal and chest congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Nasal congestion — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: Nasal congestion and dehydration.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Nasal congestion — Feeling: Good

Free text: Dehydration and slight nasal congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 7, dose 2
MedDRA: Dehydration — Feeling: Good

Free text: dehydration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Survey response — day 21, dose 2
MedDRA: Rash — Feeling: Good

Free text: Mild skin rash on fore arms and biceps during the day and at end of the day, shortly before bedtime, the rash becomes slightly moderate. Appears to be similar to eczema symptoms. In addition, symptoms persist in dehydration.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

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

Adult check-in
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Rash — Feeling: Good

Free text: Reoccurring skin rash that flares up unexpectedly on one side of body above the waist or sometimes both sides.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Congestion

Release 2 — day 7, dose 1

2021-01-15

Systemic reaction (other): Congestion

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Digestion concerns. Not severe enough to see a health care provider, but very concerning to see abnormal feces. Other concerns involve a change in skin condition from clear to breakouts. Final concern is a lack of appetite and nausea.

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Dehydrated. Dry eyes. Nasal congestion.

2021-02-07

Systemic reaction (other): Nasal congestion. Dehydration.

2021-02-08

Systemic reaction (other): Nasal congestion and dehydration.

2021-02-09

Systemic reaction (other): Dehydration, nasal and chest congestion.

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Nasal congestion and dehydration.

2021-02-11

Systemic reaction (other): Dehydration and slight nasal congestion.

Release 4 — day 7, dose 2

2021-02-12

Systemic reaction (other): dehydration

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Mild skin rash on fore arms and biceps during the day and at end of the day, shortly before bedtime, the rash becomes slightly moderate. Appears to be similar to eczema symptoms. In addition, symptoms persist in dehydration.

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Reoccurring skin rash that flares up unexpectedly on one side of body above the waist or sometimes both sides.

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	Abnormal faeces	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Dehydration	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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