3YS-33251-12989

4 vaccinations 7 coded responses 22 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 076 / NJ
Registered: 2021-03-13

Relationship: Self
Race: N/A
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-12
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-26
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache — Feeling: Fair

Free text: Extreme fatigue and headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Bone lesion, Dyspnoea, Fatigue, Respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activities

Free text: My airways are not yet cleared. I still have some shortness of breath. My fatigue and tiredness continues. I've developed a lesion on my left femur. Doctors not sure if Covid related. I'm seeing an Ortho oncologist.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Dose 3 — Moderna
2022-04-09
Survey response — 12 months, dose 2
MedDRA: Brain fog, Dyspnoea, Fatigue — Feeling: Good

Free text: Some shortness of breath Brain fog Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Dose 4 — Moderna
2022-06-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-13
Survey response — day 42, dose 4
MedDRA: Brain fog, Emergency care, Vertigo — 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: Symptoms: Ive been experimenting what I can describe as brain fog. I recently came down with vertigo. It's been 2 weeks. I just want to sleep. · Healthcare visit (other): I was doing so much better until 2 weeks ago. Had to go to the ER.

MedDRA releases: 2024-11 · check-in free text available
2022-06-13
Report sent to call center — day 42, dose 4
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)
2022-06-14
Call 1 — Left Voicemail
2022-08-01
Survey response — 3 months, dose 4
MedDRA: Brain fog, Dizziness, Fatigue, Headache, Office visit, Respiratory disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I am having chronic headaches as we as light headedness. My brain feels as if in a vacuum. My airways are not where they should be. I'm seeing a Neurologist. Have had a number of test. EEG and next week the overnight EEG. I'm constantly tired.

MedDRA releases: 2024-11 · check-in free text available
2022-08-01
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-02
Call successful
Does not wish to fill out VAERS report
2022-10-31
Survey response — 6 months, dose 4
MedDRA: Fatigue — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Slightly fatigue at time. However not bad.

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-01
Call 1 — Left Voicemail
2023-05-02
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-09	Moderna
3	2021-11-19	Moderna	No
4	2022-05-02	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): Dizzy

Release 6 — day 14, dose 1

2021-03-26

Symptoms: Extreme fatigue and headaches

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: My airways are not yet cleared. I still have some shortness of breath. My fatigue and tiredness continues. I've developed a lesion on my left femur. Doctors not sure if Covid related. I'm seeing an Ortho oncologist.

Release 11 — 12 months, dose 2

2022-04-09

Symptoms: Some shortness of breath Brain fog Fatigue

Release 12 — day 42, dose 4

2022-06-13

Symptoms: Ive been experimenting what I can describe as brain fog. I recently came down with vertigo. It's been 2 weeks. I just want to sleep.

Healthcare visit (other): I was doing so much better until 2 weeks ago. Had to go to the ER.

Release 12 — 3 months, dose 4

2022-08-01

Symptoms: I am having chronic headaches as we as light headedness. My brain feels as if in a vacuum. My airways are not where they should be. I'm seeing a Neurologist. Have had a number of test. EEG and next week the overnight EEG. I'm constantly tired.

Release 12 — 6 months, dose 4

2022-10-31

Symptoms: Slightly fatigue at time. However not bad.

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	Emergency care	·	·	✓
SD	Bone lesion	·	·	✓
SD	Brain fog	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Office visit	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Vertigo	·	·	✓
SRO	Dizziness	✓	✓	✓

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