4CN-17020-99769

2 vaccinations 14 coded responses 19 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 112 / NY
Registered: 2021-03-09

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

2021-03-05
Dose 1 — Moderna
2021-03-09
Registered in v-safe
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: COVID-19 — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: All of these symptoms are from long COVID (370 days and counting), not the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Unevaluable event — Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: From long COVID not the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Poor

Adult check-in
2021-03-26
Survey response — day 21, dose 1
MedDRA: Erythema, Lymphadenitis, Pharyngeal swelling — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Lymph nodes red & inflamed. Throat swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Dose 2 — Moderna
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Dizziness — Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness, low appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Exercise tolerance decreased, Feeling abnormal, Physiotherapy — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · 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: Systemic reaction (other): Brain fog, exercise intolerance · Healthcare visit (other): Physical therapy. I went, but they decided to not have me do any exercise.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
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)
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 7, dose 2
MedDRA: Inflammation — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Inflammation of face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 14, dose 2
MedDRA: Pyrexia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — day 21, dose 2
MedDRA: Decreased appetite, Inflammation — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: No appetite, a lot more inflammation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Dizziness, Headache, Neck pain, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Neck & head pain. Dizziness. Increase in dysautonomia symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Survey response — day 42, dose 2
MedDRA: Adverse food reaction, Sensory disturbance — Feeling: Poor

Free text: Internal nerve vibrations. Reactions to food.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-03
Survey response — 3 months, dose 2
MedDRA: Neck pain — 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: Neck pain. Suspected cervical cranial instability.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-03
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)
2021-07-07
Call 1 — Could Not Reach Participant
2021-07-12
Call 2 — Could Not Reach Participant
2021-10-03
Survey response — 6 months, dose 2
MedDRA: COVID-19, Small fibre neuropathy — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Small fiber neuropathy cause by COVID 19 infection.

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal bacterial overgrowth — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diagnosed with bacterial overgrowth in digestive system.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-03	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): All of these symptoms are from long COVID (370 days and counting), not the vaccine.

2021-03-10

Systemic reaction (other): From long COVID not the vaccine

Release 6 — day 21, dose 1

2021-03-26

Symptoms: Lymph nodes red & inflamed. Throat swollen.

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Dizziness, low appetite

2021-04-08

Systemic reaction (other): Brain fog, exercise intolerance

Healthcare visit (other): Physical therapy. I went, but they decided to not have me do any exercise.

2021-04-09

Systemic reaction (other): Brain fog

Release 7 — day 7, dose 2

2021-04-10

Systemic reaction (other): Inflammation of face

Release 7 — day 14, dose 2

2021-04-17

Symptoms: Fever

Release 7 — day 21, dose 2

2021-04-24

Symptoms: No appetite, a lot more inflammation

Release 8 — day 28, dose 2

2021-05-01

Symptoms: Neck & head pain. Dizziness. Increase in dysautonomia symptoms.

Release 8 — day 42, dose 2

2021-05-15

Symptoms: Internal nerve vibrations. Reactions to food.

Release 9 — 3 months, dose 2

2021-07-03

Symptoms: Neck pain. Suspected cervical cranial instability.

Release 9 — 6 months, dose 2

2021-10-03

Symptoms: Small fiber neuropathy cause by COVID 19 infection.

Release 11 — 12 months, dose 2

2022-04-05

Symptoms: Diagnosed with bacterial overgrowth in digestive system.

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	Physiotherapy	✓	✓	✓
SD	Adverse food reaction	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Gastrointestinal bacterial overgrowth	·	·	✓
SD	Headache	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Lymphadenitis	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pharyngeal swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Sensory disturbance	✓	✓	✓
SD	Small fibre neuropathy	·	·	✓
SRO	COVID-19	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Exercise tolerance decreased	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Unevaluable event	○	✓	○

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