2TF-27749-20590

1 vaccination 8 coded responses 14 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 321 / FL
Registered: 2021-04-10

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

2021-04-08
Dose 1 — Moderna
2021-04-10
Registered in v-safe
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Autoimmune disorder, Chest pain, Inflammation, Throat tightness — Feeling: Fair · Fever · Fatigue or tiredness

Free text: chest pain, throught tightening, blood feels aflame - nad autoimmune response symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: blood feels like lava - autoimmune response (Sjogrens)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Tremor — Feeling: Good · Headache, Fatigue or tiredness

Free text: a bit shaky

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Muscular weakness — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: arm fatigue. my husband who is not reporting in has blood in his stool following the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 7, dose 1
MedDRA: Emergency care, Haematochezia — Feeling: Fair · Headache, Fatigue or tiredness

Free text: husband has blood in his stool following same moderna shot. hes been at the ER all day. So scary.

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

Adult check-in
2021-04-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 28, dose 1
MedDRA: Diarrhoea, Dizziness, Dyschromatopsia, Headache — Feeling: Fair

Free text: hives, daily, all last weekbad headaches, dailyeye sight changes - dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-07-08
Survey response — 3 months, dose 1
MedDRA: Condition aggravated, Food allergy, Pre-existing disease, Urticaria, Visual impairment — Feeling: Good

Free text: Eye sight change, new food sensitivites and hives once a week. Mild cases. Autoimmune symptoms were very bad for a couple months following vaccination. I've been able to calm and correct them with supplements.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-07
Survey response — 6 months, dose 1
MedDRA: Office visit, Vision blurred, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: eye sight has worstened this year. not by rx, but strangley off. unexplainable and harder to focus on things · Healthcare visit (other): normal eye doc

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-11
Call 1 — Left Voicemail
2021-10-12
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-04-08
Health check-in — 12 months, dose 1
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-11

Systemic reaction (other): chest pain, throught tightening, blood feels aflame - nad autoimmune response symptoms

2021-04-12

Systemic reaction (other): blood feels like lava - autoimmune response (Sjogrens)

2021-04-13

Systemic reaction (other): a bit shaky

2021-04-14

Systemic reaction (other): arm fatigue. my husband who is not reporting in has blood in his stool following the shot.

Release 7 — day 7, dose 1

2021-04-15

Systemic reaction (other): husband has blood in his stool following same moderna shot. hes been at the ER all day. So scary.

Release 8 — day 28, dose 1

2021-05-06

Symptoms: hives, daily, all last weekbad headaches, dailyeye sight changes - dizziness

Release 9 — 3 months, dose 1

2021-07-08

Symptoms: Eye sight change, new food sensitivites and hives once a week. Mild cases. Autoimmune symptoms were very bad for a couple months following vaccination. I've been able to calm and correct them with supplements.

Release 10 — 6 months, dose 1

2021-10-07

Symptoms: eye sight has worstened this year. not by rx, but strangley off. unexplainable and harder to focus on things

Healthcare visit (other): normal eye doc

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	Office visit	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyschromatopsia	✓	✓	✓
SD	Food allergy	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vision blurred	·	·	✓
SD	Visual impairment	✓	✓	✓
SRO	Autoimmune disorder	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Haematochezia	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Throat tightness	✓	✓	✓
SRO	Tremor	✓	✓	✓

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