4V4-82450-37523

1 vaccination 10 coded responses 15 check-ins 10 free-text entries 6 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 664 / KS
Registered: 2021-03-24

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

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Moderna
2021-03-24
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Palpitations — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Racing heart and not being able to sleep cause of a weird feeling in my chest and my heart racing and waking me up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Dizziness, Palpitations — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Heart racing, dizziness, weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Fear, Nasopharyngitis, Nervousness, Palpitations, Scar, Tremor — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Heart racing when up moving around, dizziness, cold and shaky, scared

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-02
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-07
Survey response — day 14, dose 1
MedDRA: Decreased appetite, Depression, Tinnitus, Weight decreased — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Ringing in the ears that started on day 10 after my vaccine. Depression, weightloss because i dont feel like eating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — day 14, dose 1
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)
2021-04-14
Survey response — day 21, dose 1
MedDRA: Balance disorder, Depression, Fatigue, Head discomfort, Insomnia, Limb discomfort, Syncope, Tinnitus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Almost 2 weeks now of ringing in the ears and no sleep, depression, fatigue, pressure feeling in my head and face, legs feel heavy when walking, feel off balance, feel faint from time to time, arm that i had the vaccine im still hurts from time to ti

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 21, dose 1
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)
2021-04-21
Survey response — day 28, dose 1
MedDRA: Office visit, Tinnitus, Unevaluable event — Feeling: Poor · Be unable to work, 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: Symptoms: Ringing in ears getting louder · Healthcare visit (other): My pcp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 28, dose 1
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)
2021-04-28
Survey response — day 35, dose 1
MedDRA: Dizziness, Facial discomfort, Head discomfort, Tinnitus — 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

Free text: Head and facial pressure, dizziness when walking, tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 35, dose 1
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)
2021-05-05
Survey response — day 42, dose 1
MedDRA: Depression, Tinnitus — 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

Free text: Horrible tinnitus, depression, on meds now for the depression from the tinnitus. Will NOT be getting the 2nd shot due to the tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 42, dose 1
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)
2021-06-23
Survey response — 3 months, dose 1
MedDRA: Tinnitus — 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: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Report sent to call center — 3 months, dose 1
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)
2021-06-25
Call 1 — Left Voicemail
2022-03-24
Health check-in — 12 months, dose 1
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna

Call center

6 call center cases

6 unsuccessful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-24

Systemic reaction (other): Dizzy

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): Racing heart and not being able to sleep cause of a weird feeling in my chest and my heart racing and waking me up

2021-03-26

Systemic reaction (other): Heart racing, dizziness, weakness

2021-03-28

Systemic reaction (other): Heart racing when up moving around, dizziness, cold and shaky, scared

Release 7 — day 14, dose 1

2021-04-07

Symptoms: Ringing in the ears that started on day 10 after my vaccine. Depression, weightloss because i dont feel like eating

Release 7 — day 21, dose 1

2021-04-14

Symptoms: Almost 2 weeks now of ringing in the ears and no sleep, depression, fatigue, pressure feeling in my head and face, legs feel heavy when walking, feel off balance, feel faint from time to time, arm that i had the vaccine im still hurts from time to ti cut off by CDC

Release 7 — day 28, dose 1

2021-04-21

Symptoms: Ringing in ears getting louder

Healthcare visit (other): My pcp

Release 8 — day 35, dose 1

2021-04-28

Symptoms: Head and facial pressure, dizziness when walking, tinnitus

Release 8 — day 42, dose 1

2021-05-05

Symptoms: Horrible tinnitus, depression, on meds now for the depression from the tinnitus. Will NOT be getting the 2nd shot due to the tinnitus

Release 9 — 3 months, dose 1

2021-06-23

Symptoms: Tinnitus

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	Office visit	✓	·	✓
HCVO	Unevaluable event	○	✓	○
SD	Balance disorder	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Facial discomfort	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SD	Syncope	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Weight decreased	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fear	·	·	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Nervousness	✓	✓	○
SRO	Palpitations	✓	✓	✓
SRO	Scar	✓	✓	○
SRO	Tremor	·	·	✓

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