6K5-23547-63942
4 vaccinations
3 coded responses
8 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 287 / NC
- Registered
- 2021-09-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Dose 1 — Moderna
-
2021-02-26
Dose 2 — Moderna
-
2021-08-20
Dose 3 — Moderna
-
2021-09-29
Registered in v-safe
-
2021-09-29
Survey response — day 35, dose 3MedDRA: Brain fog, Fatigue, Headache, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Continued Fatigue, mild to severe headaches in back of head, and occasional brain fog · Healthcare visit (other): Brain and neck MRIMedDRA releases: 2024-11 · check-in free text available
-
2021-09-29
Report sent to call center — day 35, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-10-03
- 2021-11-22
-
2021-12-06
Call successfulParticipant prefers to complete VAERS report online
- 2022-02-20
-
2022-03-31
Dose 4 — Moderna
-
2022-05-03
Survey response — day 28, dose 4MedDRA: Brain fog, Fatigue, Headache, Vaccine positive rechallenge — Feeling: FairFree text: Severe headaches in back of head that recede and return multiple times every day. Also, more tired than usual and have some brain fog. These symptoms occurred after my first booster and lasted 5 months. Have returned about 3 weeks after my secondMedDRA releases: 2024-11 · check-in free text available
- 2022-05-08
-
2022-05-14
Survey response — day 42, dose 4MedDRA: Aphasia, Fatigue, Headache — Feeling: FairFree text: Headaches in the back of the head, extremely tired and some trouble finding words again have resumed.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | No |
| 2 | 2021-02-26 | Moderna | No |
| 3 | 2021-08-20 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 9 — day 35, dose 3
Symptoms: Continued Fatigue, mild to severe headaches in back of head, and occasional brain fog
Healthcare visit (other): Brain and neck MRI
Release 11 — day 28, dose 4
Symptoms: Severe headaches in back of head that recede and return multiple times every day. Also, more tired than usual and have some brain fog. These symptoms occurred after my first booster and lasted 5 months. Have returned about 3 weeks after my second cut off by CDC
Release 11 — day 42, dose 4
Symptoms: Headaches in the back of the head, extremely tired and some trouble finding words again have resumed.
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 | Unevaluable event | · | · | ✓ |
| SD | Aphasia | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release