6CK-33322-29069

4 vaccinations 11 coded responses 28 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 604 / IL
Registered: 2021-03-20

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Survey response — day 0, dose 1
MedDRA: Taste disorder — Feeling: Good · Site: Pain

Free text: Strange aftertaste for the first few hours after injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Headache — Feeling: Good · Diarrhea

Free text: I forgot to check in yesterday and I had a headache and faint feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Survey response — day 14, dose 1
MedDRA: Muscle spasms, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities

Free text: Very severe Charlie horses (cramps) in both of my thighs, do not think it is related to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 21, dose 1
MedDRA: Fatigue, Gastrointestinal disorder, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches when I wake up on some days and some stomach problems, may be from food but not really sure. Also more tired than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Dose 2 — Moderna
2021-04-17
Survey response — day 0, dose 2
MedDRA: Dysgeusia — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Metallic taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work

Free text: dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — day 21, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Good

Free text: I just seem to be exhausted since I had the shot, this not normal for me to fall asleep in the afternoon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-18
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme tiredness

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-28
Dose 3 — Moderna
2022-04-17
Survey response — 12 months, dose 2
MedDRA: Blood cholesterol increased, Diabetes mellitus, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Diabetes and high cholesterol · Healthcare visit (other): Found through physical

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-20
Call 1 — Left Voicemail
2022-09-17
Dose 4 — Moderna
2022-10-14
Survey response — day 21, dose 4
MedDRA: Aneurysm, Blood cholesterol increased, Diabetes mellitus, Office visit, Pulmonary congestion, Thrombosis — 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: Symptoms: I became diabetic in March as well as high cholesterol, my lungs sound congested still since February and they never were like that. Unrelated, there were 3 aneurysms found as well as a blood clot. · Healthcare visit (other): Primary dr. Follow up every 3 mos. Many specialists now

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — day 21, dose 4
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)
2022-10-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-18
Call 1 — Could Not Reach Participant
2022-10-21
Call successful
Participant prefers to complete VAERS report online
2022-10-21
Call successful
Participant prefers to complete VAERS report online
2022-10-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-17
Survey response — 3 months, dose 4
MedDRA: Aneurysm, Goitre, Thrombosis, Thyroid mass — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I developed an enlarged thyroid and nogule, I also have blood clots from 3 aneurysms that were discovered, however I do not think it would be related to the vaccine, but I'm not certain.

MedDRA releases: 2024-11 · check-in free text available
2022-12-17
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-19
Call 1 — Left Voicemail
2023-03-19
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna
3	2021-11-28	Moderna	No
4	2022-09-17	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-20

Systemic reaction (other): Strange aftertaste for the first few hours after injection

Release 6 — days 1–6 daily, dose 1

2021-03-26

Systemic reaction (other): I forgot to check in yesterday and I had a headache and faint feeling

Release 6 — day 14, dose 1

2021-04-05

Symptoms: Very severe Charlie horses (cramps) in both of my thighs, do not think it is related to the vaccine

Release 7 — day 21, dose 1

2021-04-10

Symptoms: Headaches when I wake up on some days and some stomach problems, may be from food but not really sure. Also more tired than usual.

Release 7 — day 0, dose 2

2021-04-17

Systemic reaction (other): Metallic taste

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): dizziness

Release 8 — day 21, dose 2

2021-05-10

Symptoms: I just seem to be exhausted since I had the shot, this not normal for me to fall asleep in the afternoon

Release 9 — 3 months, dose 2

2021-07-18

Symptoms: Extreme tiredness

Release 11 — 12 months, dose 2

2022-04-17

Symptoms: Diabetes and high cholesterol

Healthcare visit (other): Found through physical

Release 12 — day 21, dose 4

2022-10-14

Symptoms: I became diabetic in March as well as high cholesterol, my lungs sound congested still since February and they never were like that. Unrelated, there were 3 aneurysms found as well as a blood clot.

Healthcare visit (other): Primary dr. Follow up every 3 mos. Many specialists now

Release 12 — 3 months, dose 4

2022-12-17

Symptoms: I developed an enlarged thyroid and nogule, I also have blood clots from 3 aneurysms that were discovered, however I do not think it would be related to the vaccine, but I'm not certain.

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	Aneurysm	·	·	✓
SD	Blood cholesterol increased	·	·	✓
SD	Diabetes mellitus	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Goitre	·	·	✓
SD	Headache	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Pulmonary congestion	·	·	✓
SD	Somnolence	✓	✓	✓
SD	Thrombosis	·	·	✓
SD	Thyroid mass	·	·	✓
SD	Unevaluable event	○	✓	○
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Taste disorder	✓	✓	✓

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