37S-33971-05904

5 vaccinations 21 coded responses 39 check-ins 20 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 979 / OR
Registered: 2021-03-08

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

2021-03-04
Dose 1 — Moderna
2021-03-08
Registered in v-safe
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Good · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Ringing in the ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-11
Survey response — day 7, dose 1
MedDRA: Tinnitus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Ears are still ringing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Survey response — day 0, dose 2
MedDRA: Flushing — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Flushed feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Tinnitus — Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Ears ringing, dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Tremor — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Shakey at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus, Tremor — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ears ringing, shaky at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Good · Headache

Free text: Ears still ringing, right ear mostly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis — Feeling: Good · Headache

Free text: Nose bleed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Sinus congestion, Tinnitus — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Ringing ears, sinus congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Good · Headache, Fatigue or tiredness

Free text: Right ear still ringing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 14, dose 2
MedDRA: Hypersensitivity, Rash pustular, Self-medication — Feeling: Good

Free text: Pustular Rash persists and some new ones this week. Allergic to benadryl so im using hydrocortisone cream.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 21, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Continued ringing in right ear.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 28, dose 2
MedDRA: Rash, Tinnitus — Feeling: Good

Free text: Right ear ringing persists. Worse on some days with no apparent reason, loud and very annoying. Rash is mostly gone now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Contusion, Fatigue, Tinnitus — Feeling: Good

Free text: Increased bruising on the legs. Looks like petechiae. Ringing in my right ear is much better but returns with fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Hypersensitivity, Pre-existing disease, Self-medication — Feeling: Good · Be unable to do your normal daily activities

Free text: Severe seasonal allergies this year. I have them in August every year. This time they are more severe and OTC Flonase isn't working as it did before.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Dose 3 — Moderna
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Condition aggravated, Fatigue, Headache, Influenza like illness, Pre-existing disease — Feeling: Good

Free text: Fatigue, headaches and neuropathy flair after flu like illness.

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Dose 4 — Moderna
2022-04-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-04-30
Survey response — days 1–6 daily, dose 4
MedDRA: Nasal congestion — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

Free text: Nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-05-03
Survey response — days 1–6 daily, dose 4
MedDRA: Cough — Feeling: Good

Free text: Dry cough

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-05
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-05-12
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-26
Survey response — day 28, dose 4
MedDRA: Arthralgia, Joint stiffness, Neurological symptom, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Omincrease in neuropathy symtoms over the kast couple of weeks. Joint paint amd stiffness. I have RA and post chemotherapy for Sjogrens neuropathy.

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-30
Survey response — 3 months, dose 4
MedDRA: Alopecia, Condition aggravated, Lymphadenopathy, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My Non Hodgkins Lymphoma has flared slightly. Lymph node swelling and hair loss. · Healthcare visit (other): I saw my Oncolgy physician at my regularly sceduled 6 month checkup.

MedDRA releases: 2024-11 · check-in free text available
2022-07-30
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-11-11
Dose 5 — Moderna
2022-12-17
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-26
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-10
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-12
Survey response — 6 months, dose 5
MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-12
Report sent to call center — 6 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-15
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-11-18	Moderna	No
4	2022-04-28	Moderna	No
5	2022-11-11	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-08

Systemic reaction (other): Ringing in the ears

Release 5 — day 7, dose 1

2021-03-11

Systemic reaction (other): Ears are still ringing

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): Flushed feeling

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Ears ringing, dizzy

2021-04-03

Systemic reaction (other): Shakey at times

2021-04-04

Systemic reaction (other): Ears ringing, shaky at times

2021-04-05

Systemic reaction (other): Ears still ringing, right ear mostly

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Nose bleed

2021-04-07

Systemic reaction (other): Ringing ears, sinus congestion

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Right ear still ringing

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Pustular Rash persists and some new ones this week. Allergic to benadryl so im using hydrocortisone cream.

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Continued ringing in right ear.

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Right ear ringing persists. Worse on some days with no apparent reason, loud and very annoying. Rash is mostly gone now.

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Increased bruising on the legs. Looks like petechiae. Ringing in my right ear is much better but returns with fatigue.

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Severe seasonal allergies this year. I have them in August every year. This time they are more severe and OTC Flonase isn't working as it did before.

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Fatigue, headaches and neuropathy flair after flu like illness.

Release 11 — days 1–6 daily, dose 4

2022-04-30

Systemic reaction (other): Nasal congestion

2022-05-03

Systemic reaction (other): Dry cough

Release 11 — day 28, dose 4

2022-05-26

Symptoms: Omincrease in neuropathy symtoms over the kast couple of weeks. Joint paint amd stiffness. I have RA and post chemotherapy for Sjogrens neuropathy.

Release 12 — 3 months, dose 4

2022-07-30

Symptoms: My Non Hodgkins Lymphoma has flared slightly. Lymph node swelling and hair loss.

Healthcare visit (other): I saw my Oncolgy physician at my regularly sceduled 6 month checkup.

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	Alopecia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Contusion	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Joint stiffness	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Neurological symptom	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash pustular	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Tremor	✓	✓	✓

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