4J9-33029-75006

2 vaccinations 19 coded responses 25 check-ins 19 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 068 / CT
Registered: 2021-01-09

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

2021-01-08
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Blood pressure increased, Flushing, Heart rate increased — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: At times of injection my BP jumped to 158/110 and HR jumped to 158. I felt a flush . Happened three times within 1/2 hour then subsided.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Muscle or body aches

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Lymph nodes in neck swollen with sore throat on left

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-15
Survey response — day 7, dose 1
MedDRA: Cough, Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Fever · Fatigue or tiredness, Nausea

Free text: Painful cervical lymph node left ( same side as injection )sore throat, upper respiratory coufh

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 14, dose 1
MedDRA: Lymphadenopathy, Muscle spasms, Oropharyngeal pain, Tinnitus — Feeling: Good

Free text: Ringing in my ears three timesMuscle crampsSwollen lymph nodes left neck same side as vaccineSore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 21, dose 1
MedDRA: Dizziness, Fatigue, Respiratory tract congestion, Rhinorrhoea, Tinnitus — Feeling: Fair

Free text: I have had episodes of ringing in my ears once a day or every other day for a few moments. I have a stuffed head, runny nose and am feeling a little dizzy on and off. I have fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Dose 2 — Moderna
2021-02-05
Survey response — day 0, dose 2
MedDRA: Blood pressure increased, Heart rate increased — Feeling: Good · Site: Pain · Headache

Free text: Bp reached 156/84( normal is 118/75) and heart rate was 125 after vaccine but went down right away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Head discomfort, Tachyphrenia — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Racing thoughts when trying to sleep, dizziness, stuffed head, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Head discomfort — Feeling: Good · Site: Pain · Headache

Free text: Stuffed head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash erythematous, Rash macular — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Red splotchy rash over finger joints - mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Head discomfort, Sinus pain, Toothache — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Slightly tired, Stuffy head, upper and lower teeth hurt left side of mouth - same side as injection, sinus pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Pruritus, Respiratory tract congestion, Toothache, Urticaria — Feeling: Good · Site: Pain · Joint pains, Rash, not including the immediate area around the injection site

Free text: Random hives on legs and arms, itchy, left sided tooth pain both upper and lower, stuffed head, slight occasional dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Rash, Rash pruritic, Respiratory tract congestion, Toothache — Feeling: Good · Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Itchy rash on thighs and trunk - transient. Brain fog . Stuffy head. Left sided teeth pain upper and lower ( same side as injection ).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 7, dose 2
MedDRA: Dizziness, Headache, Pruritus, Rash, Tinnitus, Toothache — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Itchy rash on torso. Headache with study head, slight dizziness, sharp pains in head, ringing in ears only one time. Teeth left side of face hurt.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 14, dose 2
MedDRA: Facial pain, Lymphadenopathy, Office visit, Pain in jaw, Toothache, Trigeminal neuralgia — Feeling: Poor · 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: Developed severe trigeminal neuralgia left sided - started one week after second immunization involving face jaw and teeth pain . In addition developed large lymph node swelling left neck . Had to see PCP and then neurologist . Ever had this before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-26
Survey response — day 21, dose 2
MedDRA: Emergency care, Hospitalisation, Lymphadenopathy, Myocardial infarction, Osteitis, Pulmonary embolism, Tooth infection — Feeling: Poor · Be unable to work, 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, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Developed infection in previously healthy left tooth, jaw, face with hard inflam parotid gland. Saw 8 docs pre diag. . Ended in ER twice, had oral surgery to incise jaw, release pus ,pull out a tooth. Ddimer over 3,000. Elevated troponin, elev np · Healthcare visit (other): Two ER visits and one hospitalization to r/o PE, heart attack, etc

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 21, 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)
2021-03-06
Survey response — day 28, dose 2
MedDRA: Facial pain, Hospitalisation, Infection, Laboratory test abnormal, Office visit, Swelling face, Tooth extraction, White blood cell count increased — Feeling: Poor · Be unable to work, 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, Emergency room or emergency department visit, Hospitalization

Free text: Developed severe left facial pain and swelling. Had 9 MD plus 5 ER visits and was eventually admitted to hospital with severe infection of left face and jaw. Had tooth removed. Elevated WBC and other abnormal labs. Had to have IV antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Report sent to call center — day 28, 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)
2021-03-09
Call 1 — Left Voicemail
2021-03-12
Survey response — day 35, dose 2
MedDRA: Cellulitis, Emergency care, Laboratory test abnormal, Localised infection, Lymphadenopathy, Office visit, Telemedicine — Feeling: Poor · Be unable to work, 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, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: I continue to remain in antibiotics for the infection, cellulitis and lymphadenopathy I experienced in my left face starting one week after the second Moderna vaccine. The doctors can not explain the source of the infection. My labs are abnorma · Healthcare visit (other): Have had multiple visits to MDs, telehealth, 5 ER visits and one hospitalization. Please call me at (b)(6) to discuss.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 35, 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)
2021-03-19
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-08
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-08-10
Call 1 — Could Not Reach Participant
2021-08-13
Call 2 — Left Voicemail
2022-02-07
Survey response — 12 months, dose 2
MedDRA: Facial pain, Hip arthroplasty, Malaise, Osteoarthritis, Palpitations, Sinus pain, Toothache — Feeling: Fair · Be unable to work or attend school, 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, Emergency room or emergency department visit, Hospitalization

Free text: The pain in my face, sinuses, teeth continues ever since the vaccinations. I developed osteoarthritis of the hip and had to have a hip replacement also. My heart has palpitations and often races ever since the vaccinations. I have not felt healthy

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-08
Call 1 — Requested Callback
2022-02-08
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna

Call center

6 call center cases

6 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): At times of injection my BP jumped to 158/110 and HR jumped to 158. I felt a flush . Happened three times within 1/2 hour then subsided.

2021-01-13

Systemic reaction (other): Sore throat

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Lymph nodes in neck swollen with sore throat on left

Release 2 — day 7, dose 1

2021-01-15

Systemic reaction (other): Painful cervical lymph node left ( same side as injection )sore throat, upper respiratory coufh

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Ringing in my ears three timesMuscle crampsSwollen lymph nodes left neck same side as vaccineSore throat

Release 3 — day 21, dose 1

2021-01-29

Symptoms: I have had episodes of ringing in my ears once a day or every other day for a few moments. I have a stuffed head, runny nose and am feeling a little dizzy on and off. I have fatigue.

Release 3 — day 0, dose 2

2021-02-05

Systemic reaction (other): Bp reached 156/84( normal is 118/75) and heart rate was 125 after vaccine but went down right away

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Racing thoughts when trying to sleep, dizziness, stuffed head, brain fog

2021-02-07

Systemic reaction (other): Stuffed head

2021-02-08

Systemic reaction (other): Red splotchy rash over finger joints - mild

2021-02-09

Systemic reaction (other): Slightly tired, Stuffy head, upper and lower teeth hurt left side of mouth - same side as injection, sinus pain

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Random hives on legs and arms, itchy, left sided tooth pain both upper and lower, stuffed head, slight occasional dizziness

2021-02-11

Systemic reaction (other): Itchy rash on thighs and trunk - transient. Brain fog . Stuffy head. Left sided teeth pain upper and lower ( same side as injection ).

Release 4 — day 7, dose 2

2021-02-12

Systemic reaction (other): Itchy rash on torso. Headache with study head, slight dizziness, sharp pains in head, ringing in ears only one time. Teeth left side of face hurt.

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Developed severe trigeminal neuralgia left sided - started one week after second immunization involving face jaw and teeth pain . In addition developed large lymph node swelling left neck . Had to see PCP and then neurologist . Ever had this before. cut off by CDC

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Developed infection in previously healthy left tooth, jaw, face with hard inflam parotid gland. Saw 8 docs pre diag. . Ended in ER twice, had oral surgery to incise jaw, release pus ,pull out a tooth. Ddimer over 3,000. Elevated troponin, elev np

Healthcare visit (other): Two ER visits and one hospitalization to r/o PE, heart attack, etc

Release 5 — day 28, dose 2

2021-03-06

Symptoms: Developed severe left facial pain and swelling. Had 9 MD plus 5 ER visits and was eventually admitted to hospital with severe infection of left face and jaw. Had tooth removed. Elevated WBC and other abnormal labs. Had to have IV antibiotics.

Release 5 — day 35, dose 2

2021-03-12

Symptoms: I continue to remain in antibiotics for the infection, cellulitis and lymphadenopathy I experienced in my left face starting one week after the second Moderna vaccine. The doctors can not explain the source of the infection. My labs are abnorma

Healthcare visit (other): Have had multiple visits to MDs, telehealth, 5 ER visits and one hospitalization. Please call me at (b)(6) to discuss.

redacted (b)(6)

Release 11 — 12 months, dose 2

2022-02-07

Symptoms: The pain in my face, sinuses, teeth continues ever since the vaccinations. I developed osteoarthritis of the hip and had to have a hip replacement also. My heart has palpitations and often races ever since the vaccinations. I have not felt healthy

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	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Myocardial infarction	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pulmonary embolism	✓	✓	✓
HCVO	Telemedicine	✓	✓	✓
HCVO	Unevaluable event	○	○	○
SD	Cellulitis	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Facial pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hip arthroplasty	·	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Infection	✓	✓	✓
SD	Laboratory test abnormal	✓	✓	✓
SD	Localised infection	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Osteitis	✓	✓	✓
SD	Osteoarthritis	·	·	✓
SD	Pain in jaw	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sinus pain	·	·	✓
SD	Swelling face	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Tooth extraction	✓	✓	✓
SD	Tooth infection	✓	✓	✓
SD	Toothache	✓	✓	✓
SD	Trigeminal neuralgia	✓	✓	✓
SD	White blood cell count increased	✓	✓	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Tachyphrenia	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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