37V-26039-15123

2 vaccinations 16 coded responses 22 check-ins 16 free-text entries 9 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 313 / GA
Registered: 2021-03-16

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-15
Dose 1 — Moderna
2021-03-16
Registered in v-safe
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Breast feeding, Irritability — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Nursing child (2.5 years old) has irritability.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Ringing in ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — day 7, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Lymph nodes under same arm where shot was given are a little tender & enlarged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 14, dose 1
MedDRA: Fatigue, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Runny nose, sneezing, fatigue (suspected seasonal allergies)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Aura, Pre-existing disease, Seizure — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: auras (I have epilepsy and usually get auras before seizures)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Chromaturia, Heart rate increased, Palpitations — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · 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: heart pounding, rapid heart rate (around 101 bpms), dark urine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — days 1–6 daily, 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)
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Neurological symptom, Seizure — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · 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: Neurological, seizure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — days 1–6 daily, 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)
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Pain in right calf

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity, Unevaluable event — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Heart rate still in 90s-102, pain in right calf · Healthcare visit (other): Appointment scheduled with PCP for tomorrow (Monday, 04/19/21)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Report sent to call center — days 1–6 daily, 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)
2021-04-19
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-19
Report sent to call center — day 7, 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)
2021-04-26
Survey response — day 14, dose 2
MedDRA: Eosinophilia, Fatigue, Headache, Tachycardia — Feeling: Fair · 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: Extreme fatigue, headaches, increased heart rate; lab work shows abnormal reaction to vaccine, including eosinophilia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-03
Survey response — day 21, dose 2
MedDRA: Blood urine present, Brain fog, Eosinophilia, Fatigue, Headache, Heart rate increased, Malaise, Menstruation irregular, Seizure — Feeling: Fair · 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: Since the last vaccine (seizure, eosinophilia, blood in urine), I have gotten sick twice. My immune system is shot. I have recurrent headaches, fatigue, brain fog, and my heart rate is still high. Menstrual cycle is haywire. Now taking B12 injections

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
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)
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue, comes and goes but is getting better. Better with the B-12 injections.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Survey response — 3 months, dose 2
MedDRA: Extrasystoles, Eye pain, Headache, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Headaches, pain behind right eye, sometimes feels like heart skips a beat · Healthcare visit (other): Awaiting appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-15
Call 1 — Left Voicemail
2021-08-23
Call 2 — Could Not Reach Participant
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Cardiac disorder, Office visit, Ventricular extrasystoles — Feeling: Fair · 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: Since my vaccine, I have had trouble with my heart. I never had heart problems prior. I saw a cardiologist and had to wear a monitor for a few weeks. The monitor picked up PVCs, which he noted in a few patients post-vaccine. Am being followed by card

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2022-04-12
Survey response — 12 months, dose 2
MedDRA: Breast mass, Lymphadenopathy, Ventricular extrasystoles — Feeling: Fair · 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: Heart - PVCs. Scheduled for a stress test and another halter (heart monitor). Lymph nodes - Tomorrow, scheduled for a CT scan with contrast for hard lymph node in neck. Breast - Scheduled for a diagnostic mammogram for lump in right breast.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Report sent to call center — 12 months, dose 2
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 · 1 call case(s)
2022-04-14
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna

Call center

9 call center cases

9 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): Nursing child (2.5 years old) has irritability.

2021-03-18

Systemic reaction (other): Ringing in ear

Release 6 — day 7, dose 1

2021-03-23

Systemic reaction (other): Lymph nodes under same arm where shot was given are a little tender & enlarged

Release 6 — day 14, dose 1

2021-03-30

Symptoms: Runny nose, sneezing, fatigue (suspected seasonal allergies)

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): auras (I have epilepsy and usually get auras before seizures)

2021-04-15

Systemic reaction (other): heart pounding, rapid heart rate (around 101 bpms), dark urine

2021-04-16

Systemic reaction (other): Neurological, seizure

2021-04-17

Systemic reaction (other): Pain in right calf

2021-04-18

Systemic reaction (other): Heart rate still in 90s-102, pain in right calf

Healthcare visit (other): Appointment scheduled with PCP for tomorrow (Monday, 04/19/21)

Release 8 — day 14, dose 2

2021-04-26

Symptoms: Extreme fatigue, headaches, increased heart rate; lab work shows abnormal reaction to vaccine, including eosinophilia.

Release 8 — day 21, dose 2

2021-05-03

Symptoms: Since the last vaccine (seizure, eosinophilia, blood in urine), I have gotten sick twice. My immune system is shot. I have recurrent headaches, fatigue, brain fog, and my heart rate is still high. Menstrual cycle is haywire. Now taking B12 injections cut off by CDC

Release 8 — day 35, dose 2

2021-05-17

Symptoms: Fatigue, comes and goes but is getting better. Better with the B-12 injections.

Release 8 — day 42, dose 2

2021-05-24

Symptoms: Headaches

Release 9 — 3 months, dose 2

2021-07-13

Symptoms: Headaches, pain behind right eye, sometimes feels like heart skips a beat

Healthcare visit (other): Awaiting appointment

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: Since my vaccine, I have had trouble with my heart. I never had heart problems prior. I saw a cardiologist and had to wear a monitor for a few weeks. The monitor picked up PVCs, which he noted in a few patients post-vaccine. Am being followed by card cut off by CDC

Release 11 — 12 months, dose 2

2022-04-12

Symptoms: Heart - PVCs. Scheduled for a stress test and another halter (heart monitor). Lymph nodes - Tomorrow, scheduled for a CT scan with contrast for hard lymph node in neck. Breast - Scheduled for a diagnostic mammogram for lump in right breast.

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	Unevaluable event	✓	✓	✓
SD	Blood urine present	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Breast mass	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Eosinophilia	✓	✓	✓
SD	Extrasystoles	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Malaise	✓	✓	✓
SD	Menstruation irregular	✓	✓	✓
SD	Office visit	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Seizure	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Tachycardia	✓	✓	✓
SD	Ventricular extrasystoles	·	·	✓
SRO	Aura	✓	✓	✓
SRO	Breast feeding	✓	✓	✓
SRO	Chromaturia	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neurological symptom	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Seizure	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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