4U5-11627-00978

2 vaccinations 5 coded responses 16 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 928 / CA
Registered: 2021-03-19

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-19
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Dose 2 — Moderna
2021-03-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: A bit dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Impaired work ability — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Went to work, i had to come home. My thought process was foggy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-23
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-20
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Brain fog, Disturbance in attention, Dizziness, Memory impairment, Office visit, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Ringing in ears is very loud, sometimes. A bit dizzy a few times. Same joint soreness. Brain fog at work,hard to concentrate. · Healthcare visit (other): Went to see my primary Dr. After 1st shot i was ok. After second shot, i have still not fully recovered. Very concerned about my sudden brain fog, and shout term memory problem.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-20
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-29
Call 1 — Left Voicemail
2021-06-30
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-09-17
Survey response — 6 months, dose 2
MedDRA: Cardiac disorder, Office visit, Renal disorder — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: My doctor did an EKG. He says I'm having a problem with my heart. He sent me to a cardiologist. They did an echo cardiogram. Then I was told I had to wear a heart monitor for 7 days 24 hours per day, & stress ecocardigram. Kidneys are having a prob.

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Report sent to call center — 6 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)
2021-09-21
Call successful
Participant prefers to complete VAERS report online
2022-03-21
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Brain fog, Fatigue, Poor quality sleep, Tinnitus — 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

Free text: Joint pain, brain fog, ringing in ears, always tired. Not sleeping well.

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
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 · 1 call case(s)
2022-03-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): A bit dizzy

2021-03-22

Systemic reaction (other): Went to work, i had to come home. My thought process was foggy.

Release 9 — 3 months, dose 2

2021-06-20

Symptoms: Ringing in ears is very loud, sometimes. A bit dizzy a few times. Same joint soreness. Brain fog at work,hard to concentrate.

Healthcare visit (other): Went to see my primary Dr. After 1st shot i was ok. After second shot, i have still not fully recovered. Very concerned about my sudden brain fog, and shout term memory problem.

Release 9 — 6 months, dose 2

2021-09-17

Symptoms: My doctor did an EKG. He says I'm having a problem with my heart. He sent me to a cardiologist. They did an echo cardiogram. Then I was told I had to wear a heart monitor for 7 days 24 hours per day, & stress ecocardigram. Kidneys are having a prob. cut off by CDC

Release 11 — 12 months, dose 2

2022-03-21

Symptoms: Joint pain, brain fog, ringing in ears, always tired. Not sleeping well.

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	Brain fog	·	·	✓
HCVO	Memory impairment	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Cardiac disorder	·	·	✓
SD	Disturbance in attention	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Office visit	·	·	✓
SD	Poor quality sleep	·	·	✓
SD	Renal disorder	·	·	✓
SD	Tinnitus	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓

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