5Y9-20403-25686

2 vaccinations 7 coded responses 11 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 973 / OR
Registered: 2021-05-18

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

2021-04-15
Dose 1 — Moderna
2021-05-13
Dose 2 — Moderna
2021-05-18
Registered in v-safe
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Emotional disorder, Hormone level abnormal, Memory impairment, Palpitations — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Diarrhea, Rash, not including the immediate area around the injection site

Free text: Feeling like my clarity isnt right, some memory issues, also feeling like Im experiencing hormonal energy issues, hipper, emotional, heart racing etc.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Joint pains, Rash, not including the immediate area around the injection site

Free text: Still feel like I m out of sorts, but it better then it was.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Good · Joint pains, Rash, not including the immediate area around the injection site

Free text: Starting to get my energy back. Not wired like first 72 hrs after injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Survey response — day 35, dose 2
MedDRA: Epistaxis, Headache, Parosmia, Pre-existing disease — Feeling: Fair

Free text: More head aches - bloody nose for two weeks. Still smell smoke occasionally, an I dont smoke.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — day 42, dose 2
MedDRA: Alopecia, Headache, Rash — Feeling: Fair

Free text: Headaches - more often still - rash is finally starting to heal. An I dont seem to be loosing as much hair these days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-13
Survey response — 3 months, dose 2
MedDRA: Arthralgia, COVID-19, Impaired healing, Increased tendency to bruise, Parosmia, Taste disorder — Feeling: Fair

Free text: Bruising easily, still smell smoke an taste buds have changed, things dont heal easily an my joints hurt all of the time. Covid has slowly messed things up in my body. since having Covid & vaccine things have gotten worse, not better.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-13
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-05-16
Survey response — 12 months, dose 2
MedDRA: Adverse reaction, Asthma, Dyspnoea, Headache, Pre-existing disease, Vertigo — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My asthma is way worse, shortness of breath, vertigo for two months plus, headache regularly. I believe that these symptoms are from having COVID in November of 2020, I still experience things that I didn't have prior to this disease an vaccines.

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-13	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-18

Systemic reaction (other): Feeling like my clarity isnt right, some memory issues, also feeling like Im experiencing hormonal energy issues, hipper, emotional, heart racing etc.

2021-05-19

Systemic reaction (other): Still feel like I m out of sorts, but it better then it was.

Release 8 — day 7, dose 2

2021-05-22

Systemic reaction (other): Starting to get my energy back. Not wired like first 72 hrs after injection.

Release 9 — day 35, dose 2

2021-06-17

Symptoms: More head aches - bloody nose for two weeks. Still smell smoke occasionally, an I dont smoke.

Release 9 — day 42, dose 2

2021-06-24

Symptoms: Headaches - more often still - rash is finally starting to heal. An I dont seem to be loosing as much hair these days.

Release 9 — 3 months, dose 2

2021-08-13

Symptoms: Bruising easily, still smell smoke an taste buds have changed, things dont heal easily an my joints hurt all of the time. Covid has slowly messed things up in my body. since having Covid & vaccine things have gotten worse, not better.

Release 11 — 12 months, dose 2

2022-05-16

Symptoms: My asthma is way worse, shortness of breath, vertigo for two months plus, headache regularly. I believe that these symptoms are from having COVID in November of 2020, I still experience things that I didn't have prior to this disease an vaccines. cut off by CDC

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	Adverse reaction	·	·	✓
SD	Alopecia	✓	✓	✓
SD	Arthralgia	✓	·	✓
SD	Asthma	·	·	✓
SD	COVID-19	✓	·	✓
SD	Dyspnoea	·	·	✓
SD	Epistaxis	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Impaired healing	✓	·	✓
SD	Increased tendency to bruise	✓	·	✓
SD	Parosmia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Taste disorder	✓	·	✓
SD	Vertigo	·	·	✓
SRO	Emotional disorder	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hormone level abnormal	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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