526-26144-03508

2 vaccinations 10 coded responses 11 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 957 / CA
Registered: 2021-02-04

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-07
Dose 1 — Moderna
2021-02-04
Registered in v-safe
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Foot tingling

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: Hypoaesthesia, Paraesthesia — Feeling: Poor · Be unable to work

Free text: Bilateral foot numbness and tingling moving upwards to the rest of the body.

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: Hypoaesthesia, Muscular weakness, Paraesthesia — Feeling: Poor · Be unable to work

Free text: Right arm weakness, numbness and tingling and random paresthesias in different areas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 14, dose 2
MedDRA: Facial paresis, Muscular weakness, Paraesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Migratory paresthesias with random weakness of the face and extremities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 28, dose 2
MedDRA: Ageusia, Anosmia, Fine motor skill dysfunction, Migraine, Muscular weakness, Paraesthesia — Feeling: Fair · Be unable to work

Free text: Loss of smell, loss of taste, migratory paresthesias, migratory muscle weakness, fine motor skill loss.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 35, dose 2
MedDRA: Muscular weakness, Neuropathy peripheral, Paraesthesia — Feeling: Poor · Be unable to work

Free text: Extremity weakness, paresthesias, neuropathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 42, dose 2
MedDRA: Ageusia, Anosmia, Muscular weakness, Paraesthesia, Radiculopathy, Tremor — Feeling: Poor · Be unable to work

Free text: Lower and upper extremity weakness, tremors, paresthesias, loss of smell and taste. Polyradiculopathy symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Asthenia, Back pain, Brain fog, Dizziness, Exaggerated startle response, Fatigue, Hypoaesthesia, Insomnia, Paraesthesia, Temperature regulation disorder, Tremor — Feeling: Fair · Be unable to work

Free text: Temperature dysregulationContinued motor weaknessTremorsDizziness FatigueBrain fogInsomniaBack painStartle response/reflexParesthesias/numbness/tingling PLEASE CONTACT ME (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Autonomic nervous system imbalance, Exercise tolerance decreased, Gait inability, Muscular weakness, Small fibre neuropathy — 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, Emergency room or emergency department visit

Free text: Severe weakness of the lower extremities unable to exercise or walk. Diagnosis of vaccine related small fiber neuropathy and dysautonomia with mod to severe symptoms Workup for mitochondrial myopathy pending

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
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)
2021-10-13
Call 1 — Left Voicemail
2021-10-20
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Neuropathy peripheral, Postural orthostatic tachycardia syndrome — 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: Severe neuropathy and Severe POTS

MedDRA releases: 2024-11 · check-in free text available
2022-02-05
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)
2022-02-08
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna

Call center

2 call center cases

1 successful · 1 unsuccessful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Foot tingling

2021-02-06

Systemic reaction (other): Bilateral foot numbness and tingling moving upwards to the rest of the body.

2021-02-08

Systemic reaction (other): Right arm weakness, numbness and tingling and random paresthesias in different areas

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Migratory paresthesias with random weakness of the face and extremities

Release 5 — day 28, dose 2

2021-03-04

Symptoms: Loss of smell, loss of taste, migratory paresthesias, migratory muscle weakness, fine motor skill loss.

Release 5 — day 35, dose 2

2021-03-13

Symptoms: Extremity weakness, paresthesias, neuropathy

Release 5 — day 42, dose 2

2021-03-18

Symptoms: Lower and upper extremity weakness, tremors, paresthesias, loss of smell and taste. Polyradiculopathy symptoms.

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: Temperature dysregulationContinued motor weaknessTremorsDizziness FatigueBrain fogInsomniaBack painStartle response/reflexParesthesias/numbness/tingling PLEASE CONTACT ME (b)(6)

redacted (b)(6)

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Severe weakness of the lower extremities unable to exercise or walk. Diagnosis of vaccine related small fiber neuropathy and dysautonomia with mod to severe symptoms Workup for mitochondrial myopathy pending

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: Severe neuropathy and Severe POTS

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
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Autonomic nervous system imbalance	✓	·	✓
SD	Back pain	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Exaggerated startle response	✓	✓	✓
SD	Exercise tolerance decreased	✓	·	✓
SD	Facial paresis	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Fine motor skill dysfunction	✓	✓	✓
SD	Gait inability	✓	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Neuropathy peripheral	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Postural orthostatic tachycardia syndrome	·	·	✓
SD	Radiculopathy	✓	✓	✓
SD	Small fibre neuropathy	✓	·	✓
SD	Temperature regulation disorder	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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