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46L-19915-15602

2 vaccinations 11 coded responses 19 check-ins 11 free-text entries 1 call case
Sex
Male
Age at first dose
56-60
ZIP prefix
923 / CA
Registered
2021-01-27
Relationship
Self
Race
Other
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-01-25
    Dose 1 — Moderna
  2. 2021-01-27
    Registered in v-safe
  3. 2021-01-27
    Survey response — days 1–6 daily, dose 1
    MedDRA: COVID-19, Chills, Headache, Hyperhidrosis, Sluggishness — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Slugish the 26th headaches chills sweating this is the second time having covid
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None · Be unable to work
    Adult check-in
  5. 2021-01-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-30
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-01
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-02-10
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-15
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-22
    Dose 2 — Moderna
  11. 2021-02-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Good
    Free text: Cloudy mind
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Good
    Free text: Iittle logjt headed
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Good · Headache
    Free text: Cloudy head
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-03
    Survey response — day 7, dose 2
    MedDRA: Feeling abnormal, Headache — Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Heads foggy !headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-08
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-16
    Survey response — day 21, dose 2
    MedDRA: Balance disorder, Dizziness, Headache — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Light headed headache unbalanced
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-24
    Survey response — day 28, dose 2
    MedDRA: COVID-19, Feeling abnormal, Headache — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Foggy head headaches just not rt in the head i had covid 19 in november positive then agian covid-19 in late December worse went to hospital ! Do you really care because my head is not right
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-31
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  19. 2021-04-05
    Survey response — day 42, dose 2
    MedDRA: Feeling abnormal, Headache, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Heads foggy ears ringing headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-05-24
    Survey response — 3 months, dose 2
    MedDRA: Arthralgia, Asthenia, Brain fog, COVID-19, Pain in extremity, Tinnitus — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Head is foggy !left arm shoulder elbow back knee hirt really bad since vaccination on left side body feels weak !ears ringing never felt like this in my life had covid twice !Do you care if so call me (b)(6)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-08-23
    Survey response — 6 months, dose 2
    MedDRA: Headache, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Arm huurts from after first shoot ,headaches still Do you really have concern call me speak with me
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  22. 2022-02-23
    Survey response — 12 months, dose 2
    MedDRA: Tinnitus — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: Tinnitus bad ringing and hissing ,been to ear specialists twice mri done since vaccination,,It would nice to here from someone
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-02-23
    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
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  24. 2022-02-25
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-01-25Moderna
22021-02-22Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Slugish the 26th headaches chills sweating this is the second time having covid

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Cloudy mind

2021-02-27

Systemic reaction (other): Iittle logjt headed

2021-02-28

Systemic reaction (other): Cloudy head

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): Heads foggy !headaches

Release 5 — day 21, dose 2

2021-03-16

Symptoms: Light headed headache unbalanced

Release 6 — day 28, dose 2

2021-03-24

Symptoms: Foggy head headaches just not rt in the head i had covid 19 in november positive then agian covid-19 in late December worse went to hospital ! Do you really care because my head is not right

Release 6 — day 42, dose 2

2021-04-05

Symptoms: Heads foggy ears ringing headaches

Release 8 — 3 months, dose 2

2021-05-24

Symptoms: Head is foggy !left arm shoulder elbow back knee hirt really bad since vaccination on left side body feels weak !ears ringing never felt like this in my life had covid twice !Do you care if so call me (b)(6)
redacted (b)(6)

Release 9 — 6 months, dose 2

2021-08-23

Symptoms: Arm huurts from after first shoot ,headaches still Do you really have concern call me speak with me

Release 11 — 12 months, dose 2

2022-02-23

Symptoms: Tinnitus bad ringing and hissing ,been to ear specialists twice mri done since vaccination,,It would nice to here from someone

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDBack pain · · ○
SDBalance disorder ✓ ✓ ✓
SDBrain fog ✓ ✓ ✓
SDCOVID-19 ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDFeeling abnormal ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDPain in extremity ✓ · ✓
SDTinnitus ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROCOVID-19 ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROSluggishness ✓ ✓ ✓

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

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