2VA-19499-23669

2 vaccinations 9 coded responses 13 check-ins 9 free-text entries 5 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 921 / CA
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Food craving — Feeling: Fair · Fatigue or tiredness

Free text: Appetite for protein and dairy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Appetite for protein and nutritional value

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Survey response — day 28, dose 1
MedDRA: Unevaluable event — Feeling: Poor

Free text: Dizzy from exhaust fumes due to five hours waiting at(b)(6) for vaccine appointment and still waiting. Line moving almost not at all, now at (b)(6)@ (b)(6) St.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy possibly carbon monoxide waiting for vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 14, dose 2
MedDRA: Chills, Dizziness, Fatigue, Pain, Parosmia, Taste disorder — 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: Severe fatigue, mild dizziness, taste changes, mild pains and chills, episodes of smelling strong cigarette smoke that is not there

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 14, 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)
2021-03-19
Survey response — day 21, dose 2
MedDRA: Dizziness, Energy increased, Fatigue, Feeling abnormal — 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, Outpatient clinic or urgent care clinic visit

Free text: Dizzy fatigue with severe brain fog, very high will-power needed to work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 21, 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)
2021-03-25
Survey response — day 28, dose 2
MedDRA: Abdominal pain upper, Ageusia, Anosmia, Dizziness, Ear pain, Fatigue, Feeling abnormal, Headache, Laboratory test, Muscle disorder, Tinnitus — 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: Symptoms: Fatigue with mild dizziness (variable), thick brain fog; episodes of: headache, stomach ache, smell/taste suppression, tinnitus- earache augmentation. Elevated task error rate, especially muscular clumsiness. · Healthcare visit (other): Testing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 28, 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)
2021-04-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Fatigue, Office visit, Pre-existing disease — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Severe fatigue persists and my pre-existing pains and tinnitus are worsening.Covid antibody test is off the measurement scale, over 2500. Too disabled to do pre-Covid activities. I am a Covid long hauler from the wait/vaccine rather than the virus. · Healthcare visit (other): Many tests including C/T scans

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
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)
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Asthenia, Deafness, Depression, Ear pain, Fatigue, Immunisation reaction, Pre-existing disease, 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: Fatigue, low energy, worse ear and wrist pain, hearing loss, depression, fluctuations but no improvement trend after six months. Summary: Vaccine induced post-viral syndrome (Long Hauler). · Healthcare visit (other): specialist appointment not until November

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
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)
2021-08-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna

Call center

5 call center cases

5 unsuccessful

VAERS report filed, before or during a call: 5

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-30

Systemic reaction (other): Appetite for protein and dairy

2021-02-01

Systemic reaction (other): Appetite for protein and nutritional value

Release 4 — day 28, dose 1

2021-02-25

Symptoms: Dizzy from exhaust fumes due to five hours waiting at(b)(6) for vaccine appointment and still waiting. Line moving almost not at all, now at (b)(6)@ (b)(6) St.

redacted (b)(6)

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): Dizzy possibly carbon monoxide waiting for vaccine

Release 5 — day 14, dose 2

2021-03-11

Symptoms: Severe fatigue, mild dizziness, taste changes, mild pains and chills, episodes of smelling strong cigarette smoke that is not there

Release 5 — day 21, dose 2

2021-03-19

Symptoms: Dizzy fatigue with severe brain fog, very high will-power needed to work.

Release 6 — day 28, dose 2

2021-03-25

Symptoms: Fatigue with mild dizziness (variable), thick brain fog; episodes of: headache, stomach ache, smell/taste suppression, tinnitus- earache augmentation. Elevated task error rate, especially muscular clumsiness.

Healthcare visit (other): Testing

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: Severe fatigue persists and my pre-existing pains and tinnitus are worsening.Covid antibody test is off the measurement scale, over 2500. Too disabled to do pre-Covid activities. I am a Covid long hauler from the wait/vaccine rather than the virus. cut off by CDC

Healthcare visit (other): Many tests including C/T scans

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Fatigue, low energy, worse ear and wrist pain, hearing loss, depression, fluctuations but no improvement trend after six months. Summary: Vaccine induced post-viral syndrome (Long Hauler).

Healthcare visit (other): specialist appointment not until November

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	Laboratory test	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Arthralgia	✓	·	✓
SD	Asthenia	✓	·	✓
SD	Chills	✓	✓	✓
SD	Deafness	✓	·	✓
SD	Depression	✓	·	✓
SD	Dizziness	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Energy increased	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Immunisation reaction	✓	·	✓
SD	Muscle disorder	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Parosmia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Taste disorder	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Food craving	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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