6NS-20312-13110

2 vaccinations 6 coded responses 25 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 479 / IN
Registered: 2021-02-09

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

2021-02-09
Registered in v-safe
2021-02-09
Dose 1 — Moderna
2021-02-09
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Joint pains

Free text: I have mixed connective tissue disease do I ache often but nothing out of the ordinary

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Muscle or body aches

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 7, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Extreme fatigue for two days where I was in bed but not sure it was from vaccine .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Headache, Diarrhea

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — day 14, dose 2
MedDRA: Hypoaesthesia, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Numbness in right foot and going up right leg think a flare from my shot due to my autoimmune

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 35, dose 2
MedDRA: Office visit, Vertigo — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Vertigo that probably isnt related to the vaccine · Healthcare visit (other): Eye doctor , neurologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 42, dose 2
MedDRA: Office visit, Vertigo — Feeling: Good · 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: Vertigo still for greater than 9 days · Healthcare visit (other): Neurologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Survey response — 3 months, dose 2
MedDRA: Dizziness, Office visit, Pre-existing disease — 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, Emergency room or emergency department visit

Free text: Symptoms: Been dx with POTS, had extreme dizziness for over 1 month · Healthcare visit (other): Specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
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)
2021-06-21
Call successful
Does not wish to fill out VAERS report
2021-09-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Moderna
2	2021-03-09	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-09

Systemic reaction (other): I have mixed connective tissue disease do I ache often but nothing out of the ordinary

Release 4 — day 14, dose 1

2021-02-23

Symptoms: Extreme fatigue for two days where I was in bed but not sure it was from vaccine .

Release 6 — day 14, dose 2

2021-03-23

Symptoms: Numbness in right foot and going up right leg think a flare from my shot due to my autoimmune

Release 7 — day 35, dose 2

2021-04-13

Symptoms: Vertigo that probably isnt related to the vaccine

Healthcare visit (other): Eye doctor , neurologist

Release 7 — day 42, dose 2

2021-04-22

Symptoms: Vertigo still for greater than 9 days

Healthcare visit (other): Neurologist

Release 9 — 3 months, dose 2

2021-06-10

Symptoms: Been dx with POTS, had extreme dizziness for over 1 month

Healthcare visit (other): Specialist

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	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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