ZNR-12190-03787

2 vaccinations 16 coded responses 23 check-ins 16 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 358 / AL
Registered: 2021-04-14

Relationship: Self
Race: White
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

2021-04-13
Dose 1 — Moderna
2021-04-14
Registered in v-safe
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Ear discomfort — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Rash, not including the immediate area around the injection site

Free text: Ear pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dehydration — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Dehyration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Injection site bruising, Joint stiffness, Musculoskeletal stiffness, Pre-existing disease — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Ibs and sciatica aggrivated. Big bruise at injection site. Muscle and joint stiffness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Lacrimation increased — Feeling: Fair · Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: Eyes keep tearing...dry eye condition for since day 2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal stiffness, Peripheral swelling — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Stiffness in back and have bump on hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Survey response — day 7, dose 1
MedDRA: Dehydration, Muscle spasms, Pain, Pre-existing disease, Sciatica — Feeling: Fair · Site: Itching · Fever · Chills, Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sciatica pain muscle cramps dehydration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — day 14, dose 1
MedDRA: Eye irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Burning eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 21, dose 1
MedDRA: Neuralgia, Pruritus, Rash — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Nerve pain very bad and harder to keep hydrated. More rashes and itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 28, dose 1
MedDRA: Abdominal pain upper, Haemorrhoids, Nausea, Pyrexia, Sciatica — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Sciatica nerve increased so bad i cannot work. Feverish because hemerroids, nausea, stomach aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Dose 2 — Moderna
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Dehydration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling cold, Musculoskeletal stiffness — Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches

Free text: No chills but cold and stiff

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-21
Survey response — day 7, dose 2
MedDRA: Joint stiffness, Musculoskeletal stiffness — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stiffness muscular and jjoints

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-04
Survey response — day 21, dose 2
MedDRA: Abdominal distension, Blood magnesium decreased, Blood potassium decreased, Dehydration, Skin odour abnormal — Feeling: Good

Free text: Bad body odor low potassium and magnesium levels. Increased liver bloating. Increase dehydration.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 28, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Survey response — day 35, dose 2
MedDRA: Dehydration, Pruritus, Skin odour abnormal — Feeling: Good · Be unable to work or attend school

Free text: Body odor still bad. Itching and dehydration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Survey response — day 42, dose 2
MedDRA: Electrolyte imbalance, Hormone level abnormal, Musculoskeletal stiffness, Pruritus — Feeling: Fair

Free text: Itching and stiffness worse..hormones and electrokytes off

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-14
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Moderna
2	2021-05-14	Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-14

Systemic reaction (other): Ear pressure

2021-04-15

Systemic reaction (other): Dehyration

2021-04-16

Systemic reaction (other): Ibs and sciatica aggrivated. Big bruise at injection site. Muscle and joint stiffness

2021-04-17

Systemic reaction (other): Eyes keep tearing...dry eye condition for since day 2

2021-04-18

Systemic reaction (other): Stiffness in back and have bump on hand

Release 7 — day 7, dose 1

2021-04-20

Systemic reaction (other): Sciatica pain muscle cramps dehydration

Release 8 — day 14, dose 1

2021-04-27

Symptoms: Burning eyes

Release 8 — day 21, dose 1

2021-05-04

Symptoms: Nerve pain very bad and harder to keep hydrated. More rashes and itching

Release 8 — day 28, dose 1

2021-05-11

Symptoms: Sciatica nerve increased so bad i cannot work. Feverish because hemerroids, nausea, stomach aches

Release 8 — days 1–6 daily, dose 2

2021-05-17

Systemic reaction (other): Dehydration

2021-05-18

Systemic reaction (other): No chills but cold and stiff

Release 8 — day 7, dose 2

2021-05-21

Systemic reaction (other): Stiffness muscular and jjoints

Release 8 — day 21, dose 2

2021-06-04

Symptoms: Bad body odor low potassium and magnesium levels. Increased liver bloating. Increase dehydration.

Release 9 — day 28, dose 2

2021-06-11

Symptoms: Insomnia

Release 9 — day 35, dose 2

2021-06-18

Symptoms: Body odor still bad. Itching and dehydration

Release 9 — day 42, dose 2

2021-06-25

Symptoms: Itching and stiffness worse..hormones and electrokytes off

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	Abdominal distension	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Blood magnesium decreased	✓	✓	✓
SD	Blood potassium decreased	✓	✓	✓
SD	Dehydration	✓	✓	✓
SD	Electrolyte imbalance	✓	✓	✓
SD	Eye irritation	✓	✓	✓
SD	Haemorrhoids	✓	✓	✓
SD	Hormone level abnormal	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Sciatica	✓	✓	✓
SD	Skin odour abnormal	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Dehydration	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Joint stiffness	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sciatica	✓	✓	✓

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