6BX-13441-63278

4 vaccinations 7 coded responses 28 check-ins 7 free-text entries 0 call cases

Sex: —
Age at first dose: 21-25
ZIP prefix: 490 / MI
Registered: 2021-01-28

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Dysgeusia, Feeling abnormal — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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 do your normal daily activities

Free text: Dizziness, new slight loss of taste (can taste but things taste weird/different flavor, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Feeling abnormal, Hypersomnia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Brain fog, new loss of taste (can't taste sugar, only salty things), super sensitive to smell (can smell more than normal)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: New loss of taste (can barely taste anything at all), dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · 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

Free text: Some taste came back but not all; dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Nausea

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Survey response — day 0, dose 2
MedDRA: Amnesia, Confusional state, Dizziness, Dyspnoea, Feeling abnormal, Presyncope — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, lightheadedness, near fainting (used wheelchair), shortness of breath, confusion/memory loss, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Rash, Syncope — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash on neck and ankles. Still very dizzy and faint

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Syncope — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, faint, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
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
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-10
Dose 3 — Moderna
2021-12-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-23
Dose 4 — Moderna
Co-administered: Flu
2022-11-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-09-10	Moderna	No
4	2022-09-23	Moderna	Flu

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Dizziness, new slight loss of taste (can taste but things taste weird/different flavor, brain fog

2021-01-30

Systemic reaction (other): Brain fog, new loss of taste (can't taste sugar, only salty things), super sensitive to smell (can smell more than normal)

2021-01-31

Systemic reaction (other): New loss of taste (can barely taste anything at all), dizziness

2021-02-01

Systemic reaction (other): Some taste came back but not all; dizziness

Release 4 — day 0, dose 2

2021-02-25

Systemic reaction (other): Dizziness, lightheadedness, near fainting (used wheelchair), shortness of breath, confusion/memory loss, brain fog

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Rash on neck and ankles. Still very dizzy and faint

2021-02-28

Systemic reaction (other): Dizzy, faint, lightheaded

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
SRO	Ageusia	✓	✓	✓
SRO	Amnesia	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Presyncope	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Syncope	✓	✓	✓

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