2EM-30521-89211

1 vaccination 7 coded responses 10 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 301 / GA
Registered: 2021-08-29

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

2021-08-27
Dose 1 — Moderna
2021-08-29
Registered in v-safe
2021-08-31
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Tingling & numbness in hands & feet

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-01
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea exertional, Hypoaesthesia, Paraesthesia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Numbness & tingling in hands & feet, dyspnea on exertion

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-05
Survey response — day 7, dose 1
MedDRA: Dyspnoea exertional, Vertigo — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Vertigo, severe dyspnea on exertion

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-05
Report sent to call center — day 7, dose 1
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)
2021-09-09
Call successful
Participant prefers to complete VAERS report online
2021-09-12
Survey response — day 14, dose 1
MedDRA: Anal incontinence, Arthralgia, Coordination abnormal, Dyspnoea exertional, Muscle fatigue, Paraesthesia, Urinary incontinence — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Intermittent dyspnea on exertion, paresthesia in all 4 extremities, pain in all joints, severe muscle fatigue, loss of motor coordination, intermittent loss of bladder & bowel function

MedDRA releases: 2024-11 · check-in free text available
2021-09-12
Report sent to call center — day 14, dose 1
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)
2021-09-14
Call 1 — Left Voicemail
2021-09-17
Health check-in — day 21, dose 1
Feeling: Poor

Adult check-in
2021-10-01
Survey response — day 35, dose 1
MedDRA: Coordination abnormal, Incontinence — Feeling: Poor · Be unable to work or attend school

Free text: Loss of coordination, intermittent incontinence

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Survey response — 3 months, dose 1
MedDRA: Aphasia, Limb discomfort, Visual impairment — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Visual trails when I look at something moving in front of me. Prolonged episodes of"Losing my words" while having a conversation, now lasting several minutes at a time. sudden heaviness in all 4 limbs simultaneously & lasting 5-10 minutes

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Survey response — 6 months, dose 1
MedDRA: Arthralgia, Mental impairment, Vertigo — 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 · Outpatient clinic or urgent care clinic visit

Free text: Persistent vertigo, joint pain, difficulty with mental recall

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-28
Call 1 — Could Not Reach Participant
2022-03-03
Call 2 — Left Voicemail
2022-03-03
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-08-27
Health check-in — 12 months, dose 1
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-27	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-31

Systemic reaction (other): Tingling & numbness in hands & feet

2021-09-01

Systemic reaction (other): Numbness & tingling in hands & feet, dyspnea on exertion

Release 9 — day 7, dose 1

2021-09-05

Systemic reaction (other): Vertigo, severe dyspnea on exertion

Release 9 — day 14, dose 1

2021-09-12

Symptoms: Intermittent dyspnea on exertion, paresthesia in all 4 extremities, pain in all joints, severe muscle fatigue, loss of motor coordination, intermittent loss of bladder & bowel function

Release 9 — day 35, dose 1

2021-10-01

Symptoms: Loss of coordination, intermittent incontinence

Release 10 — 3 months, dose 1

2021-11-29

Symptoms: Visual trails when I look at something moving in front of me. Prolonged episodes of"Losing my words" while having a conversation, now lasting several minutes at a time. sudden heaviness in all 4 limbs simultaneously & lasting 5-10 minutes

Release 11 — 6 months, dose 1

2022-02-25

Symptoms: Persistent vertigo, joint pain, difficulty with mental recall

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	Anal incontinence	·	·	✓
SD	Aphasia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Coordination abnormal	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Incontinence	·	·	✓
SD	Limb discomfort	·	·	✓
SD	Mental impairment	·	·	✓
SD	Muscle fatigue	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Urinary incontinence	·	·	✓
SD	Vertigo	·	·	✓
SD	Visual impairment	·	·	✓
SRO	Dyspnoea exertional	✓	·	✓
SRO	Hypoaesthesia	✓	·	✓
SRO	Paraesthesia	✓	·	✓
SRO	Vertigo	✓	·	✓

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