39C-18182-97777

3 vaccinations 15 coded responses 27 check-ins 14 free-text entries 5 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 857 / AZ
Registered: 2021-04-08

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

2021-04-08
Registered in v-safe
2021-04-08
Dose 1 — Moderna
2021-04-08
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Hypogeusia — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sense of taste is diminished; metallic taste in mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: Dizzy

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: Dizziness — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Survey response — day 14, dose 1
MedDRA: Chills, Dizziness, Feeling abnormal, Headache, Rash, Rash erythematous, Skin warm, Sleep disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: Huge rash on arm started Sunday April 18, red and hot to touch. Also that day started chills and headache and dizzy again. Lasted until Wednesday April 21. Brain fog continues and sleep has also been disrupted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 21, dose 1
MedDRA: Dizziness, Fatigue, Pain, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus infection; dizzy; fatigue; body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — day 28, dose 1
MedDRA: Dizziness, Fatigue, Headache, Office visit, Pain, Sinusitis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, dizzy, sinus infection requiring antibiotics so was advised to wait in the second shot. Body aches continue. Also continue to have headaches daily. · Healthcare visit (other): Doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 28, dose 1
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)
2021-05-12
Dose 2 — Moderna
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dysgeusia — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, metallic taste in mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Palpitations — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy, heart racing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Somnolence — Feeling: Good · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy and groggy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-05-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — day 21, dose 2
MedDRA: Dizziness, Fatigue, Influenza like illness, Office visit, Pain, Pyrexia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Feel like i have the flu. Fever, body aches, dizzy, tired. · Healthcare visit (other): Pcp visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
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)
2021-06-11
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-11
Survey response — 3 months, dose 2
MedDRA: Body temperature increased, Fatigue, Immune system disorder, Office visit, Poor quality sleep — 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

Free text: Symptoms: Low immune system, fatigue, poor sleep and elevated body temp · Healthcare visit (other): Immunologist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-11
Report sent to call center — 3 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)
2021-08-17
Callback requested for
03:00PM ET
2021-08-17
Callback requested for
03:00PM ET
2021-08-17
Call 2 — Left Voicemail
2021-08-17
Callback requested for
03:00PM ET
2021-11-10
Survey response — 6 months, dose 2
MedDRA: Adrenal insufficiency, Epstein-Barr virus infection, Gastrointestinal bacterial overgrowth, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Epstein barr virus active, cebo and low adrenals · Healthcare visit (other): Doctors office

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
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

no matching call case
2022-01-22
Dose 3 — Moderna
2022-05-12
Survey response — 12 months, dose 2
MedDRA: Influenza — 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: Currently have influenza A

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-13
Call 1 — Left Voicemail
2022-05-13
Call 1 — Left Voicemail
2022-05-13
Call 1 — Left Voicemail
2022-05-13
Call 1 — Left Voicemail
2023-01-22
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Fatigue, Pain in extremity, Palpitations — Feeling: Fair · 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

MedDRA releases: 2024-11
2023-01-22
Report sent to call center — 12 months, dose 3
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 · Emergency room or emergency department visit · 1 call case(s)
2023-01-23
Call successful
Participant prefers to complete VAERS report online
2023-01-23
Call successful
Participant prefers to complete VAERS report online
2023-01-23
Call successful
Participant prefers to complete VAERS report online
2023-01-23
Call successful
Participant prefers to complete VAERS report online
2023-01-23
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna
2	2021-05-12	Moderna
3	2022-01-22	Moderna	No

Call center

5 call center cases

5 successful

1 wait over 3 months for a first call

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Sense of taste is diminished; metallic taste in mouth

2021-04-11

Systemic reaction (other): Dizzy

2021-04-12

Systemic reaction (other): Dizzy

Release 7 — day 14, dose 1

2021-04-22

Symptoms: Huge rash on arm started Sunday April 18, red and hot to touch. Also that day started chills and headache and dizzy again. Lasted until Wednesday April 21. Brain fog continues and sleep has also been disrupted.

Release 8 — day 21, dose 1

2021-04-29

Symptoms: Sinus infection; dizzy; fatigue; body aches

Release 8 — day 28, dose 1

2021-05-06

Symptoms: Fatigue, dizzy, sinus infection requiring antibiotics so was advised to wait in the second shot. Body aches continue. Also continue to have headaches daily.

Healthcare visit (other): Doctor

Release 8 — days 1–6 daily, dose 2

2021-05-13

Systemic reaction (other): Dizzy, metallic taste in mouth

2021-05-15

Systemic reaction (other): Dizzy

2021-05-17

Systemic reaction (other): Dizzy, heart racing

2021-05-18

Systemic reaction (other): Dizzy and groggy.

Release 8 — day 21, dose 2

2021-06-03

Symptoms: Feel like i have the flu. Fever, body aches, dizzy, tired.

Healthcare visit (other): Pcp visit

Release 9 — 3 months, dose 2

2021-08-11

Symptoms: Low immune system, fatigue, poor sleep and elevated body temp

Healthcare visit (other): Immunologist

Release 10 — 6 months, dose 2

2021-11-10

Symptoms: Epstein barr virus active, cebo and low adrenals

Healthcare visit (other): Doctors office

Release 11 — 12 months, dose 2

2022-05-12

Symptoms: Currently have influenza A

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	Adrenal insufficiency	·	·	✓
SD	Arthralgia	·	·	✓
SD	Body temperature increased	✓	·	✓
SD	Chills	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Epstein-Barr virus infection	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Gastrointestinal bacterial overgrowth	·	·	✓
SD	Headache	✓	✓	✓
SD	Immune system disorder	✓	·	✓
SD	Influenza	·	·	✓
SD	Influenza like illness	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Palpitations	·	·	✓
SD	Poor quality sleep	✓	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Sleep disorder	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Hypogeusia	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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