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4E9-25849-72266

4 vaccinations 22 coded responses 36 check-ins 22 free-text entries 4 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
342 / FL
Registered
2021-02-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-14
    Dose 1 — Moderna
  2. 2021-02-11
    Registered in v-safe
  3. 2021-02-11
    Dose 2 — Moderna
  4. 2021-02-11
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  5. 2021-02-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Tinnitus — Feeling: Good · Site: Pain
    Free text: Tinnitus
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-02-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site warmth, Tinnitus — Feeling: Good
    Free text: Tinnitus, and slight warmth at injection site.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Tinnitus — Feeling: Good
    Free text: Tinnitus (ringing in ears). Note: I had more severe reactions after FIRST Covid vaccination than second vaccination. I suspect that I may have had intestinal Covid way back in January, 2020, when I spent six weeks in NYC. That might explain why I reacted more from fist vaccination than second.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Tinnitus — Feeling: Good
    Free text: Tinnitus,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-18
    Survey response — day 7, dose 2
    MedDRA: Tinnitus — Feeling: Good
    Free text: Tinnitus
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-25
    Survey response — day 14, dose 2
    MedDRA: Asthenia, Chills, Pelvic discomfort, Urinary tract infection — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Chills, no energy, discomfort in pelvis. Probably urinary tract infection.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-05
    Survey response — day 21, dose 2
    MedDRA: Decreased appetite, Dizziness, Feeding disorder, Gait inability, Hyperacusis, Loss of consciousness, Movement disorder, Nausea, Parosmia, Photophobia, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: Severe nausea and vomiting, brief loss of consciousness, dizziness, unable to stand or walk, extreme sensitivity to light, odors and sound, unable to eat or drink except small sips of water.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-11
    Survey response — day 28, dose 2
    MedDRA: Office visit, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Urinary tract infection. Starting antibiotics today. · Healthcare visit (other): In person visit with Gynocologist.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-11
    Report sent to call center — day 28, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-03-18
    Survey response — day 35, dose 2
    MedDRA: Dizziness, Office visit, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Diagnosed with urinary tract infection, prescribed antibiotic Nitrofurantoin Mono-MCR 100 MG, 2 times per day for 5 days. Continued light headedness when reclined for sleep at night. · Healthcare visit (other): In patient visit one week ago.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-18
    Report sent to call center — day 35, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2021-03-25
    Survey response — day 42, dose 2
    MedDRA: Asthenia, Dizziness, Gait disturbance, Mobility decreased, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Dizziness when waking in morning. Very unstable when walking. Need to change positions very slowly to rise from bed. Dizzy symptoms subside somewhat after about ten minutes. Feel more fragile during the day. Good day today. · Healthcare visit (other): Scheduled in person doctor visit.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-03-25
    Report sent to call center — day 42, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  20. 2021-05-13
    Survey response — 3 months, dose 2
    MedDRA: Genital discomfort, Urinary tract infection — Feeling: Good · 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: Urinary tract infection. Other genital discomfort.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-05-13
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  22. 2021-08-12
    Survey response — 6 months, dose 2
    MedDRA: Ageusia, Anosmia, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities
    Free text: Loss of smell and taste about one month ago.. Acute loss for three days, then smell and taste returned over the next week. (I now believe I had Intestinal Covid in January 2020, acquired in (b)(6) early in pandemic. )
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  23. 2021-11-16
    Dose 3 — Moderna
  24. 2021-11-17
    Survey response — days 1–6 daily, dose 3
    MedDRA: Thirst — Feeling: Poor · Site: Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Very thirsty
    MedDRA releases: 2024-11 · check-in free text available
  25. 2021-11-18
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  26. 2021-11-19
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site swelling — Feeling: Good · Site: Swelling
    Free text: Slight swelling at injection site yesterday which I barely noticed and did not report.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2021-11-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  28. 2021-11-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  29. 2021-11-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Fatigue or tiredness, Diarrhea
    Adult check-in
  30. 2021-11-23
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  31. 2021-11-30
    Survey response — day 14, dose 3
    MedDRA: Asthenia, Decreased appetite, Diarrhoea — Feeling: Good · Be unable to do your normal daily activities
    Free text: About five days of mild diarrhea, poor appetite and slightly weak. About three days ago I became well and have been well since.
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-12-07
    Survey response — day 21, dose 3
    MedDRA: Eye pruritus, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities
    Free text: Severe respiratory allergies. Sensitivity to mold, mildew, dust pollen, etc. Also, itchy eyes.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-12-14
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  34. 2021-12-21
    Survey response — day 35, dose 3
    MedDRA: Rash — Feeling: Good
    Free text: Rash on chest. May be from insect bites; I was outside in warm climate.
    MedDRA releases: 2024-11 · check-in free text available
  35. 2021-12-28
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-02-15
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  37. 2022-03-04
  38. 2022-04-05
    Call successful
    Completed over the phone
  39. 2022-05-04
    Dose 4 — Moderna
  40. 2022-05-12
    Survey response — day 7, dose 4
    MedDRA: Fatigue, Injection site pain, Pain — Feeling: Good
    Free text: May 5, the day after shot, slight ache at injection site and very slight tiredness/body ache.
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-05-18
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  42. 2022-05-27
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-06-01
    Survey response — day 28, dose 4
    MedDRA: Diarrhoea — Feeling: Good
    Free text: Slight diarrhea
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-06-08
    Survey response — day 35, dose 4
    MedDRA: Atrial fibrillation, Dizziness — Feeling: Good
    Free text: Slight morning dizziness for several days. One incident of early morning, slight, passing, atrial fibrillation.
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-06-15
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  46. 2022-08-03
    Survey response — 3 months, dose 4
    MedDRA: Dizziness, Mobility decreased, Photophobia, SARS-CoV-2 test negative, Vomiting — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Severe dizziness, vomiting, light sensitivity, unable to move from bed for 24 hours on Friday, July 29, 2022. Slowly improving for 5 days. Slight dizziness this morning; feeling better now. Negative Covid test.
    MedDRA releases: 2024-11 · check-in free text available
  47. 2022-11-04
    Survey response — 6 months, dose 4
    MedDRA: Dizziness — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Extreme dizziness July30-31.Four weeks recovery before I was completely better.Delayed reaction to vaccine?Afraid to have most recent vaccine because friends around the world have experienced similar symptoms.Do you have other dizziness reports?
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-14Moderna
22021-02-11Moderna
32021-11-16Moderna No
42022-05-04Moderna No

Call center

4 call center cases

4 successful

VAERS report filed, before or during a call: 4

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Tinnitus

2021-02-14

Systemic reaction (other): Tinnitus, and slight warmth at injection site.

2021-02-15

Systemic reaction (other): Tinnitus (ringing in ears). Note: I had more severe reactions after FIRST Covid vaccination than second vaccination. I suspect that I may have had intestinal Covid way back in January, 2020, when I spent six weeks in NYC. That might explain why I reacted more from fist vaccination than second.

2021-02-17

Systemic reaction (other): Tinnitus,

Release 4 — day 7, dose 2

2021-02-18

Systemic reaction (other): Tinnitus

Release 4 — day 14, dose 2

2021-02-25

Symptoms: Chills, no energy, discomfort in pelvis. Probably urinary tract infection.

Release 5 — day 21, dose 2

2021-03-05

Symptoms: Severe nausea and vomiting, brief loss of consciousness, dizziness, unable to stand or walk, extreme sensitivity to light, odors and sound, unable to eat or drink except small sips of water.

Release 5 — day 28, dose 2

2021-03-11

Symptoms: Urinary tract infection. Starting antibiotics today.
Healthcare visit (other): In person visit with Gynocologist.

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Diagnosed with urinary tract infection, prescribed antibiotic Nitrofurantoin Mono-MCR 100 MG, 2 times per day for 5 days. Continued light headedness when reclined for sleep at night.
Healthcare visit (other): In patient visit one week ago.

Release 6 — day 42, dose 2

2021-03-25

Symptoms: Dizziness when waking in morning. Very unstable when walking. Need to change positions very slowly to rise from bed. Dizzy symptoms subside somewhat after about ten minutes. Feel more fragile during the day. Good day today.
Healthcare visit (other): Scheduled in person doctor visit.

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Urinary tract infection. Other genital discomfort.

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Loss of smell and taste about one month ago.. Acute loss for three days, then smell and taste returned over the next week. (I now believe I had Intestinal Covid in January 2020, acquired in (b)(6) early in pandemic. )
redacted (b)(6)

Release 10 — days 1–6 daily, dose 3

2021-11-17

Systemic reaction (other): Very thirsty

2021-11-19

Systemic reaction (other): Slight swelling at injection site yesterday which I barely noticed and did not report.

Release 10 — day 14, dose 3

2021-11-30

Symptoms: About five days of mild diarrhea, poor appetite and slightly weak. About three days ago I became well and have been well since.

Release 10 — day 21, dose 3

2021-12-07

Symptoms: Severe respiratory allergies. Sensitivity to mold, mildew, dust pollen, etc. Also, itchy eyes.

Release 10 — day 35, dose 3

2021-12-21

Symptoms: Rash on chest. May be from insect bites; I was outside in warm climate.

Release 11 — day 7, dose 4

2022-05-12

Systemic reaction (other): May 5, the day after shot, slight ache at injection site and very slight tiredness/body ache.

Release 11 — day 28, dose 4

2022-06-01

Symptoms: Slight diarrhea

Release 11 — day 35, dose 4

2022-06-08

Symptoms: Slight morning dizziness for several days. One incident of early morning, slight, passing, atrial fibrillation.

Release 12 — 3 months, dose 4

2022-08-03

Symptoms: Severe dizziness, vomiting, light sensitivity, unable to move from bed for 24 hours on Friday, July 29, 2022. Slowly improving for 5 days. Slight dizziness this morning; feeling better now. Negative Covid test.

Release 12 — 6 months, dose 4

2022-11-04

Symptoms: Extreme dizziness July30-31.Four weeks recovery before I was completely better.Delayed reaction to vaccine?Afraid to have most recent vaccine because friends around the world have experienced similar symptoms.Do you have other dizziness reports?

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
HCVOOffice visit ✓ ✓ ✓
HCVOUnevaluable event ✓ ✓ ✓
SDAgeusia ✓ · ✓
SDAnosmia ✓ · ✓
SDAsthenia ✓ ✓ ✓
SDAtrial fibrillation · · ✓
SDChills ✓ ✓ ✓
SDDecreased appetite ✓ ✓ ✓
SDDiarrhoea · · ✓
SDDizziness ✓ ✓ ✓
SDEye pruritus · · ✓
SDFeeding disorder ✓ ✓ ✓
SDGait disturbance ✓ ✓ ✓
SDGait inability ✓ ✓ ✓
SDGenital discomfort ✓ ✓ ✓
SDHyperacusis ✓ ✓ ✓
SDLoss of consciousness ✓ ✓ ✓
SDMobility decreased ✓ ✓ ✓
SDMovement disorder ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDParosmia ✓ ✓ ✓
SDPelvic discomfort ✓ ✓ ✓
SDPhotophobia ✓ ✓ ✓
SDPre-existing disease ✓ · ✓
SDRash · · ✓
SDSARS-CoV-2 test negative · · ✓
SDUrinary tract infection ✓ ✓ ✓
SDVomiting ✓ ✓ ✓
SROFatigue · · ✓
SROInjection site pain · · ✓
SROInjection site swelling · · ✓
SROInjection site warmth ✓ ✓ ✓
SROPain · · ✓
SROThirst · · ✓
SROTinnitus ✓ ✓ ✓

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

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