29R-21917-75452

2 vaccinations 10 coded responses 20 check-ins 10 free-text entries 10 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 112 / NY
Registered: 2021-01-13

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

2021-01-11
Dose 1 — Moderna
2021-01-13
Registered in v-safe
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Survey response — day 7, dose 1
MedDRA: Medical counselling — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Pain doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: You didn't ask what I experienced for the three days after the vaccine. Why?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — day 7, dose 2
Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness, Abdominal pain · Be unable to work

Adult check-in
2021-02-19
Survey response — day 14, dose 2
MedDRA: Abnormal dreams, Decreased appetite, Fatigue, Feeling abnormal, Hypersomnia, Weight decreased — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Severe fatigue, weight loss 5 lbs since second vaccine with lots of appetite. Vivid, crazy, dreams, sleeping a lot. Brain fog. Some of these are symptoms I had when I had COVID in March.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-26
Survey response — day 21, dose 2
MedDRA: Fatigue, Hypotension — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue, low blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — day 28, dose 2
MedDRA: Dystonia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dystonia of both hands and left leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Survey response — day 35, dose 2
MedDRA: Hypotension, Syncope — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Hypotension and fainting. My BP has been as low as 75/55.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 42, dose 2
MedDRA: Hypotension — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My blood pressure is dangerously low. It goes as low as 75/55, and sometimes it is too low to get a reading

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Call 1 — Left Voicemail
2021-05-07
Survey response — 3 months, dose 2
MedDRA: Hospitalisation — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: 3 episodes of drop attacks. Never had before. Hospitalized last weekend b/o TIA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Aphasia, Cataplexy, Diplopia, Paralysis, Transient ischaemic attack — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization

Free text: 3 episodes of cataplexy with flaccid paralysis of all limbs. One episode of double vision. One episode aphasia. Diagnosed with TIA.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Brain fog, Fatigue, Office visit, Sinus arrest, Thinking abnormal, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I developed a sinus arrest and my heart didn't beat for 5 seconds. I was very symptomatic. My doctors say my heart is fine so they don't know why it happened. I am also increasingly fatigued, exhausted, and brain fogged. My head isempty of thoughts. · Healthcare visit (other): I'm getting a pacemaker

MedDRA releases: 2024-11 · check-in free text available
2022-02-05
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-07
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-05	Moderna

Call center

10 call center cases

10 successful

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-18

Healthcare visit (other): Pain doctor

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): You didn't ask what I experienced for the three days after the vaccine. Why?

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Severe fatigue, weight loss 5 lbs since second vaccine with lots of appetite. Vivid, crazy, dreams, sleeping a lot. Brain fog. Some of these are symptoms I had when I had COVID in March.

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Fatigue, low blood pressure

Release 5 — day 28, dose 2

2021-03-07

Symptoms: Dystonia of both hands and left leg

Release 5 — day 35, dose 2

2021-03-12

Symptoms: Hypotension and fainting. My BP has been as low as 75/55.

Release 5 — day 42, dose 2

2021-03-19

Symptoms: My blood pressure is dangerously low. It goes as low as 75/55, and sometimes it is too low to get a reading

Release 8 — 3 months, dose 2

2021-05-07

Symptoms: 3 episodes of drop attacks. Never had before. Hospitalized last weekend b/o TIA

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: 3 episodes of cataplexy with flaccid paralysis of all limbs. One episode of double vision. One episode aphasia. Diagnosed with TIA.

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: I developed a sinus arrest and my heart didn't beat for 5 seconds. I was very symptomatic. My doctors say my heart is fine so they don't know why it happened. I am also increasingly fatigued, exhausted, and brain fogged. My head isempty of thoughts. cut off by CDC

Healthcare visit (other): I'm getting a pacemaker

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
HCVO	Medical counselling	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Abnormal dreams	✓	✓	✓
SD	Aphasia	✓	·	✓
SD	Brain fog	·	·	✓
SD	Cataplexy	✓	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Diplopia	✓	·	✓
SD	Dystonia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Hypersomnia	✓	✓	✓
SD	Hypotension	✓	✓	✓
SD	Office visit	·	·	✓
SD	Paralysis	✓	·	✓
SD	Sinus arrest	·	·	✓
SD	Syncope	✓	✓	✓
SD	Thinking abnormal	·	·	✓
SD	Transient ischaemic attack	✓	·	✓
SD	Weight decreased	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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