52Z-16960-19413

3 vaccinations 12 coded responses 19 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 212 / MD
Registered: 2021-03-01

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

2021-01-29
Dose 1 — Moderna
2021-02-26
Dose 2 — Moderna
2021-03-01
Registered in v-safe
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort, Tinnitus — Feeling: Fair · Site: Pain · Chills

Free text: Tinnitus and pressure in ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Tinnitus — Feeling: Poor · Chills, Fatigue or tiredness

Free text: Tinnitus, nasal stuffiness mild,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — day 14, dose 2
MedDRA: Rhinorrhoea, Sneezing — Feeling: Good

Free text: One day when i sneezed alot and had runny nose. I have no history of nasal allergies or spontaneous sneezing 2, 3 times in a row 3 times in one day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 28, dose 2
MedDRA: Vertigo — Feeling: Good

Free text: Mild vertigo when getting up from weeding. Or compound axis head motions.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Balance disorder, Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Since I got the vaccine. I noticed a slight reoccurrence of my viral labyrinthits, with minor infrequent balance episodes. Was non existent before vaccines. Otherwise ferl great

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-27
Dose 3 — Moderna
2021-10-27
Survey response — day 0, dose 3
MedDRA: Dizziness, Skin laceration, Syncope — Feeling: Fair · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Fainting spell day after shot · Healthcare visit (other): Very ditzy after shot. Cut thumb and fainted

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Report sent to call center — day 0, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Vertigo — Feeling: Good

Free text: Slightly vertiginous when climbing up and down ladder

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Call 1 — Left Voicemail
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Balance disorder — Feeling: Good · Site: Pain

Free text: Slow to revover balance when arising form laying down

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Office visit, Rash — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Pale rash developed on outer left thigh · Healthcare visit (other): Dermatologists

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Rash — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Still have rash on outer left thigh

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Vertigo, Vertigo positional — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Vertiginous when getting up from sleep and exercising

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Call 1 — Left Voicemail
2021-11-03
Call successful
Participant prefers to complete VAERS report online
2021-11-04
Survey response — day 7, dose 3
MedDRA: Office visit, Rash — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Rash on outer left upper thigh · Healthcare visit (other): Dermatologist

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-08
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-10-27	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Tinnitus and pressure in ear

2021-03-02

Systemic reaction (other): Tinnitus, nasal stuffiness mild,

Release 5 — day 14, dose 2

2021-03-12

Symptoms: One day when i sneezed alot and had runny nose. I have no history of nasal allergies or spontaneous sneezing 2, 3 times in a row 3 times in one day

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Mild vertigo when getting up from weeding. Or compound axis head motions.

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Since I got the vaccine. I noticed a slight reoccurrence of my viral labyrinthits, with minor infrequent balance episodes. Was non existent before vaccines. Otherwise ferl great

Release 10 — day 0, dose 3

2021-10-27

Systemic reaction (other): Fainting spell day after shot

Healthcare visit (other): Very ditzy after shot. Cut thumb and fainted

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Slightly vertiginous when climbing up and down ladder

2021-10-29

Systemic reaction (other): Slow to revover balance when arising form laying down

2021-10-30

Systemic reaction (other): Pale rash developed on outer left thigh

Healthcare visit (other): Dermatologists

2021-11-01

Systemic reaction (other): Still have rash on outer left thigh

2021-11-02

Systemic reaction (other): Vertiginous when getting up from sleep and exercising

Release 10 — day 7, dose 3

2021-11-04

Systemic reaction (other): Rash on outer left upper thigh

Healthcare visit (other): Dermatologist

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	Dizziness	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Skin laceration	·	·	✓
HCVO	Syncope	·	·	✓
SD	Balance disorder	✓	·	✓
SD	Condition aggravated	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Balance disorder	·	·	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Syncope	·	·	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vertigo	·	·	✓
SRO	Vertigo positional	·	·	✓

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