6A5-11643-45542

4 vaccinations 31 coded responses 45 check-ins 30 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 450 / OH
Registered: 2021-02-04

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Nausea

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Good

Free text: Eye blurring

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Survey response — day 0, dose 2
MedDRA: Tinnitus — Feeling: Fair · Chills, Headache, Fatigue or tiredness

Free text: Ringing in rars

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Ringing ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Tinnitus — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: Temporal pain ear ringing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Tinnitus — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness

Free text: Temple pain ears ring

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Tinnitus — Feeling: Good · Site: Itching

Free text: Ring ears temple pain

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

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — day 14, dose 2
MedDRA: Headache, Tendonitis — Feeling: Good

Free text: Head pain. Tendon swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 28, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Pain in muscle of arm where injection was given.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 35, dose 2
MedDRA: Myalgia — Feeling: Good

Free text: Sore muscle in arm vaccinated still

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 42, dose 2
MedDRA: Pain in extremity, Tinnitus — Feeling: Fair

Free text: Pain in arm buzzing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Survey response — 3 months, dose 2
MedDRA: Mobility decreased, Myalgia, Pain in extremity, Tinnitus, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Arm where shot hurts as day given. Muscle pain. Hard to move arm. Also extreme buzzing in ears since vaccine. 3 different buzzing sounds. Have to see ENT soon. Buzzing or chirping constant. No relief till I sleep · Healthcare visit (other): Soon ENT

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Survey response — 6 months, dose 2
MedDRA: Office visit, Tinnitus — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tinnitus is very severe today and moderate others. Constant buzzing in one side and cicada chirping in other. Never stops. Last thing falling asleep and first thing upon wakening. Ent sees no ear problem

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-22
Dose 3 — Moderna
2021-11-02
Survey response — day 7, dose 3
MedDRA: Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — day 14, dose 3
MedDRA: Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tinnitus severe

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — day 21, dose 3
MedDRA: Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tinnitus loud at times. Put on wrong chart. Not David but Karen.

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Survey response — day 28, dose 3
MedDRA: Hypoacusis, Tinnitus — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe tinnitus and hearing difficulty

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — day 35, dose 3
MedDRA: Tinnitus — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tinnitus is severe. Isn't clearing up at all.

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Survey response — day 42, dose 3
MedDRA: Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe tinnitus. No relief or stopping since April.

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Office visit, Tinnitus — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still severe tinnitus. Saw ENT and neurologist · Healthcare visit (other): ENT and Neurologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-25
Call 1 — Left Voicemail
2022-05-25
Dose 4 — Moderna
2022-05-27
Survey response — days 1–6 daily, dose 4
MedDRA: Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Tinnitus still

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Survey response — days 1–6 daily, dose 4
MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-05-29
Survey response — days 1–6 daily, dose 4
MedDRA: Tinnitus — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Tinnitus is real bad today

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Survey response — days 1–6 daily, dose 4
MedDRA: Hypoaesthesia, Tinnitus — Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Numbness in toe then later tip of finger and the next day on top of finger on other hand. It is totally numb then goes away after several hours. Tinnitus off chart.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — day 7, dose 4
MedDRA: Rash, Tinnitus — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Tinnitus and rash

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Survey response — day 14, dose 4
MedDRA: Pruritus, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tinnitus is severe. If any study to be done please let me know. Also still have spots that come up and itch's

MedDRA releases: 2024-11 · check-in free text available
2022-06-16
Survey response — day 21, dose 4
MedDRA: Rash, Tinnitus — Feeling: Fair

Free text: Tinnitus and rash

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Survey response — day 28, dose 4
MedDRA: Joint noise, Neck pain, Tinnitus — 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: Tinnitus and neck pain and cracking.

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-23
Call successful
Participant prefers to complete VAERS report online
2022-06-30
Survey response — day 35, dose 4
MedDRA: Crepitations, Tinnitus — Feeling: Fair

Free text: Tinnitus and crackling of neck

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Survey response — day 42, dose 4
MedDRA: Fatigue, Rash, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Rash on arms, tinnitus and tired

MedDRA releases: 2024-11 · check-in free text available
2022-08-25
Health check-in — 3 months, dose 4
Feeling: Poor

Adult check-in
2022-11-25
Survey response — 6 months, dose 4
MedDRA: Headache, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in head after vaccine. Still have severe tinnitus

MedDRA releases: 2024-11 · check-in free text available
2023-05-25
Survey response — 12 months, dose 4
MedDRA: Back pain, Tinnitus — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-10-22	Moderna	No
4	2022-05-25	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-07

Systemic reaction (other): Eye blurring

Release 5 — day 0, dose 2

2021-03-04

Systemic reaction (other): Ringing in rars

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Ringing ears

2021-03-06

Systemic reaction (other): Temporal pain ear ringing

2021-03-07

Systemic reaction (other): Temple pain ears ring

2021-03-08

Systemic reaction (other): Ring ears temple pain

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Head pain. Tendon swelling

Release 6 — day 28, dose 2

2021-04-01

Symptoms: Pain in muscle of arm where injection was given.

Release 7 — day 35, dose 2

2021-04-08

Symptoms: Sore muscle in arm vaccinated still

Release 7 — day 42, dose 2

2021-04-16

Symptoms: Pain in arm buzzing in ears

Release 8 — 3 months, dose 2

2021-06-05

Symptoms: Arm where shot hurts as day given. Muscle pain. Hard to move arm. Also extreme buzzing in ears since vaccine. 3 different buzzing sounds. Have to see ENT soon. Buzzing or chirping constant. No relief till I sleep

Healthcare visit (other): Soon ENT

Release 9 — 6 months, dose 2

2021-09-02

Symptoms: Tinnitus is very severe today and moderate others. Constant buzzing in one side and cicada chirping in other. Never stops. Last thing falling asleep and first thing upon wakening. Ent sees no ear problem

Release 10 — day 7, dose 3

2021-11-02

Systemic reaction (other): Tinnitus

Release 10 — day 14, dose 3

2021-11-05

Symptoms: Tinnitus severe

Release 10 — day 21, dose 3

2021-11-13

Symptoms: Tinnitus loud at times. Put on wrong chart. Not David but Karen.

Release 10 — day 28, dose 3

2021-11-21

Symptoms: Severe tinnitus and hearing difficulty

Release 10 — day 35, dose 3

2021-11-26

Symptoms: Tinnitus is severe. Isn't clearing up at all.

Release 10 — day 42, dose 3

2021-12-03

Symptoms: Severe tinnitus. No relief or stopping since April.

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Still severe tinnitus. Saw ENT and neurologist

Healthcare visit (other): ENT and Neurologist

Release 11 — days 1–6 daily, dose 4

2022-05-27

Systemic reaction (other): Tinnitus still

2022-05-28

Systemic reaction (other): Tinnitus

2022-05-29

Systemic reaction (other): Tinnitus is real bad today

2022-05-31

Systemic reaction (other): Numbness in toe then later tip of finger and the next day on top of finger on other hand. It is totally numb then goes away after several hours. Tinnitus off chart.

Release 11 — day 7, dose 4

2022-06-01

Systemic reaction (other): Tinnitus and rash

Release 11 — day 14, dose 4

2022-06-08

Symptoms: Tinnitus is severe. If any study to be done please let me know. Also still have spots that come up and itch's

Release 12 — day 21, dose 4

2022-06-16

Symptoms: Tinnitus and rash

Release 12 — day 28, dose 4

2022-06-22

Symptoms: Tinnitus and neck pain and cracking.

Release 12 — day 35, dose 4

2022-06-30

Symptoms: Tinnitus and crackling of neck

Release 12 — day 42, dose 4

2022-07-08

Symptoms: Rash on arms, tinnitus and tired

Release 12 — 6 months, dose 4

2022-11-25

Symptoms: Pain in head after vaccine. Still have severe tinnitus

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	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Back pain	·	·	✓
SD	Crepitations	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypoacusis	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Joint noise	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Office visit	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	Tendonitis	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Rash	·	·	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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