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5J9-10964-23647

3 vaccinations 8 coded responses 38 check-ins 8 free-text entries 4 call cases
Sex
Female
Age at first dose
21-25
ZIP prefix
310 / GA
Registered
2021-01-19
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-19
    Registered in v-safe
  2. 2021-01-19
    Dose 1 — Moderna
  3. 2021-01-19
    Survey response — day 0, dose 1
    MedDRA: Asthenia — Feeling: Good · Site: Pain, Redness · Chills, Headache, Fatigue or tiredness
    Free text: Weakness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  5. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-01-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness
    Adult check-in
  7. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Joint pains
    Adult check-in
  8. 2021-01-26
    Health check-in — day 7, dose 1
    Feeling: Good · Nausea
    Adult check-in
  9. 2021-02-02
    Survey response — day 14, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities
    Free text: Sjögrens flare up
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-09
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-16
    Survey response — day 28, dose 1
    MedDRA: Autonomic nervous system imbalance, Loss of consciousness, Palpitations — Feeling: Fair · 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: My dysautonomia has been awful. It was well controlled with medication before the 1st vaccine. Ive noticed that ever since the vaccine, all of my dysautonomia symptoms have been worse. I pass out often, heart races, etc
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-16
    Report sent to call center — day 28, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-02-17
    Dose 2 — Moderna
  14. 2021-02-17
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  15. 2021-02-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Condition aggravated, Loss of consciousness, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · 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
    Free text: I have blacked out multiple times since getting the second dose (I have dysautonomia that has significantly worsened since my first dose). My autoimmune issues have been awful. I feel like Im dying.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-18
    Report sent to call center — days 1–6 daily, 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)
  17. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  18. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  19. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness
    Adult check-in
  20. 2021-02-24
    Survey response — day 7, dose 2
    MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Good · Headache, Fatigue or tiredness
    Free text: My POTS/Dysautonomia has been bad since the first vaccine. I went to my cardiologist and pulmonologist today and they said the vaccine probably caused a flare up.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-03-03
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-10
    Survey response — day 21, dose 2
    MedDRA: Ear pain, Fatigue, Headache, Lymphadenopathy — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Bad headache, fatigue, swollen lymph nodes, ear ache. I dont think it is from the Covid vaccine, rather a flare up in underlying health issues (Sjogrens)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-03-17
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-24
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-31
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-21
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-08-10
    Call successful
    Does not wish to fill out VAERS report
  28. 2021-08-18
    Dose 3 — Moderna
  29. 2021-08-18
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  30. 2021-08-18
    Health check-in — day 0, dose 3
    Feeling: Fair · Site: Pain · Headache
    Adult check-in
  31. 2021-08-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  32. 2021-08-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain
    Adult check-in
  33. 2021-08-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  34. 2021-08-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  35. 2021-08-23
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Redness · Headache
    Adult check-in
  36. 2021-08-24
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Redness · Fatigue or tiredness, Nausea, Abdominal pain
    Adult check-in
  37. 2021-08-25
    Health check-in — day 7, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  38. 2021-09-01
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-09-09
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-09-15
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-09-22
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-09-29
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  43. 2021-11-17
    Survey response — 3 months, dose 3
    MedDRA: Aphasia, Migraine, Pre-existing disease — 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 · Outpatient clinic or urgent care clinic visit
    Free text: I have had intense migraines, I have struggled to think and form sentences. Not sure if it's from the vaccine or my underlying conditions (Sjogren's, pots, renal tubular acidosis)
    MedDRA releases: 2024-11 · check-in free text available
  44. 2021-11-17
    Report sent to call center — 3 months, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  45. 2021-11-18
  46. 2022-02-18
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  47. 2022-08-18
    Survey response — 12 months, dose 3
    MedDRA: Cardiac murmur, Polycystic ovarian syndrome — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: PCOS, heart murmur
    MedDRA releases: 2024-11 · check-in free text available
  48. 2022-08-18
    Report sent to call center — 12 months, dose 3
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  49. 2022-08-19
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-01-19Moderna
22021-02-17Moderna
32021-08-18Moderna No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-19

Systemic reaction (other): Weakness

Release 3 — day 14, dose 1

2021-02-02

Symptoms: Sjögrens flare up

Release 4 — day 28, dose 1

2021-02-16

Symptoms: My dysautonomia has been awful. It was well controlled with medication before the 1st vaccine. Ive noticed that ever since the vaccine, all of my dysautonomia symptoms have been worse. I pass out often, heart races, etc

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): I have blacked out multiple times since getting the second dose (I have dysautonomia that has significantly worsened since my first dose). My autoimmune issues have been awful. I feel like Im dying.

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): My POTS/Dysautonomia has been bad since the first vaccine. I went to my cardiologist and pulmonologist today and they said the vaccine probably caused a flare up.

Release 5 — day 21, dose 2

2021-03-10

Symptoms: Bad headache, fatigue, swollen lymph nodes, ear ache. I dont think it is from the Covid vaccine, rather a flare up in underlying health issues (Sjogrens)

Release 10 — 3 months, dose 3

2021-11-17

Symptoms: I have had intense migraines, I have struggled to think and form sentences. Not sure if it's from the vaccine or my underlying conditions (Sjogren's, pots, renal tubular acidosis)

Release 12 — 12 months, dose 3

2022-08-18

Symptoms: PCOS, heart murmur

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

FieldPreferred term2021-092023-042024-11
SDAphasia · · ✓
SDAutonomic nervous system imbalance ✓ ✓ ✓
SDCardiac murmur · · ✓
SDEar pain ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDLoss of consciousness ✓ ✓ ✓
SDLymphadenopathy ✓ ✓ ✓
SDMigraine · · ✓
SDPalpitations ✓ ✓ ✓
SDPolycystic ovarian syndrome · · ✓
SDPre-existing disease · · ✓
SDUnevaluable event ✓ ✓ ✓
SROAsthenia ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROLoss of consciousness ✓ ✓ ✓
SROOffice visit ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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

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