5Y4-24488-83762

1 vaccination 12 coded responses 15 check-ins 12 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 637 / MO
Registered: 2021-01-23

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

2021-01-22
Dose 1 — Moderna
2021-01-23
Registered in v-safe
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Feeling abnormal, Paraesthesia, Paraesthesia oral — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Tingling of lips, hands, feet and brain fog.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis — Feeling: Poor · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Cognitive disorder, Hypoaesthesia, Hypoaesthesia oral, Medical counselling — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Numbness in lips, hands, feet. Major cognative impairment. · Healthcare visit (other): Called 3 providers and told to see my PCP. He's out and rescheduled for 2 weeks. I'll be going to ER if I can't get help.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Report sent to call center — days 1–6 daily, 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)
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Cognitive disorder — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Decreased cognitive ability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 7, dose 1
MedDRA: Dyspnoea exertional, Hypoaesthesia, Swollen tongue — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen tongue, numbness in extremities, shortness of breath with any physical exertion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-12
Survey response — day 21, dose 1
MedDRA: Balance disorder, Dizziness — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Off balance/dizzy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 28, dose 1
MedDRA: Arthralgia, Fatigue, Feeling abnormal, Headache, Paraesthesia, Paraesthesia oral — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches and fatigue are worse this week. Tingling in hands, feet, lips and face are worse. Joint pain worse. Brain fog worse. Due to weather can't get to Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 35, dose 1
Feeling: Poor

Adult check-in
2021-03-05
Survey response — day 42, dose 1
MedDRA: Dyspnoea, Headache — 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: Breathing and headaches are worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
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)
2021-04-23
Survey response — 3 months, dose 1
MedDRA: Dyspnoea, Lung disorder, Office visit — 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: Symptoms: PFT shows diminished lung function. Waiting on CT results. Breathing is becoming harder. · Healthcare visit (other): Office visit, labs, testing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — 3 months, 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)
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-07-23
Survey response — 6 months, dose 1
MedDRA: Headache, Hyperhidrosis, Insomnia, Respiratory 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Headaches, insomnia, sweats, breathing issues.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
Report sent to call center — 6 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)
2021-07-29
Call 1 — Left Voicemail
2022-01-22
Survey response — 12 months, dose 1
MedDRA: Arthralgia, Cognitive disorder, Fatigue, Myalgia, Nasal congestion — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe joint and muscle pain. Cognitive issues. Fatigue.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Tingling of lips, hands, feet and brain fog.

2021-01-24

Systemic reaction (other): Sweats

2021-01-26

Systemic reaction (other): Sweating

2021-01-27

Systemic reaction (other): Numbness in lips, hands, feet. Major cognative impairment.

Healthcare visit (other): Called 3 providers and told to see my PCP. He's out and rescheduled for 2 weeks. I'll be going to ER if I can't get help.

2021-01-28

Systemic reaction (other): Decreased cognitive ability

Release 3 — day 7, dose 1

2021-01-29

Systemic reaction (other): Swollen tongue, numbness in extremities, shortness of breath with any physical exertion.

Release 4 — day 21, dose 1

2021-02-12

Symptoms: Off balance/dizzy.

Release 4 — day 28, dose 1

2021-02-19

Symptoms: Headaches and fatigue are worse this week. Tingling in hands, feet, lips and face are worse. Joint pain worse. Brain fog worse. Due to weather can't get to Dr.

Release 5 — day 42, dose 1

2021-03-05

Symptoms: Breathing and headaches are worse.

Release 7 — 3 months, dose 1

2021-04-23

Symptoms: PFT shows diminished lung function. Waiting on CT results. Breathing is becoming harder.

Healthcare visit (other): Office visit, labs, testing.

Release 9 — 6 months, dose 1

2021-07-23

Symptoms: Headaches, insomnia, sweats, breathing issues.

Release 11 — 12 months, dose 1

2022-01-22

Symptoms: Severe joint and muscle pain. Cognitive issues. Fatigue.

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Cognitive disorder	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	✓	·	✓
SD	Insomnia	✓	·	✓
SD	Lung disorder	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Paraesthesia	✓	✓	✓
SD	Paraesthesia oral	✓	✓	✓
SD	Respiratory disorder	✓	·	✓
SRO	Brain fog	✓	·	✓
SRO	Cognitive disorder	✓	✓	✓
SRO	Dyspnoea exertional	✓	✓	✓
SRO	Feeling abnormal	○	✓	○
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Swollen tongue	✓	✓	✓

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