3QD-18286-78067

1 vaccination 9 coded responses 14 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 531 / WI
Registered: 2021-03-24

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

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Moderna
2021-03-24
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Headache

Free text: Lightheaded a bit dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Dyspnoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Dizzy lightheaded heaviness breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia oral — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: On the first day I also had tingling around mouth ( lips) this only lasted a short time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — day 14, dose 1
MedDRA: Dizziness, Dyspnoea, Feeling abnormal, Feeling cold, Headache, Muscle spasms, Night sweats — Feeling: Fair

Free text: Lightheaded for 2-3 days one night heavy night sweats felt very cold,trouble breathing, same night.fogginess slight headache. Very bad leg cramps.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 21, dose 1
MedDRA: Asthenia, Body temperature increased, COVID-19, Dyspnoea, Headache, Nausea, Office visit, Pain, Vomiting — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: I was diagnosed with positive Covid on on April12,2021 I have severe headaches Im extremely weak trouble breathing and nausea and vomiting temperature is 101.2 severe body aches · Healthcare visit (other): MD office consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Survey response — day 28, dose 1
MedDRA: SARS-CoV-2 test positive — 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: Positive Covid

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 28, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 42, dose 1
MedDRA: Dyspnoea exertional, Headache, Somnolence — Feeling: Good

Free text: Daily headaches and out of breathe when walking and have to take naps every day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Survey response — 3 months, dose 1
MedDRA: Arthralgia, Dizziness, Fatigue, Gait disturbance, Hypertension, Myalgia, Oedema, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Severe hypertension. Pitting edema feet and ankles. Pain touching feet and ankles.Tired. Struggling to walk. Lightheaded. Severe muscle and joint pain especially at night in bed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Report sent to call center — 3 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Call 1 — Could Not Reach Participant
2022-03-26
Survey response — 12 months, dose 1
MedDRA: Blood cholesterol increased, Blood pressure increased, Depression, Dizziness, Headache, Insomnia, Mood swings — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Elevated Blood Pressure Dizzy spells depression high cholesterol mood swings headaches trouble sleeping

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-28
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-24

Systemic reaction (other): Lightheaded a bit dizzy

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): Dizzy lightheaded heaviness breathing

2021-03-26

Systemic reaction (other): On the first day I also had tingling around mouth ( lips) this only lasted a short time.

Release 7 — day 14, dose 1

2021-04-07

Symptoms: Lightheaded for 2-3 days one night heavy night sweats felt very cold,trouble breathing, same night.fogginess slight headache. Very bad leg cramps.

Release 7 — day 21, dose 1

2021-04-14

Symptoms: I was diagnosed with positive Covid on on April12,2021 I have severe headaches Im extremely weak trouble breathing and nausea and vomiting temperature is 101.2 severe body aches

Healthcare visit (other): MD office consultation

Release 7 — day 28, dose 1

2021-04-21

Symptoms: Positive Covid

Release 8 — day 42, dose 1

2021-05-05

Symptoms: Daily headaches and out of breathe when walking and have to take naps every day.

Release 9 — 3 months, dose 1

2021-06-23

Symptoms: Severe hypertension. Pitting edema feet and ankles. Pain touching feet and ankles.Tired. Struggling to walk. Lightheaded. Severe muscle and joint pain especially at night in bed.

Release 11 — 12 months, dose 1

2022-03-26

Symptoms: Elevated Blood Pressure Dizzy spells depression high cholesterol mood swings headaches trouble sleeping

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	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Blood cholesterol increased	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Body temperature increased	✓	✓	✓
SD	COVID-19	✓	✓	✓
SD	Depression	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Dyspnoea exertional	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Feeling cold	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Mood swings	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	Oedema	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	SARS-CoV-2 test positive	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓

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