F6Z-11630-14123

2 vaccinations 9 coded responses 9 check-ins 9 free-text entries 7 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 197 / DE
Registered: 2021-03-25

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

2021-02-08
Dose 1 — Moderna
2021-03-15
Dose 2 — Moderna
2021-03-25
Registered in v-safe
2021-03-25
Survey response — day 7, dose 2
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Numbness tingling in extremities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 14, dose 2
MedDRA: Muscular weakness — Feeling: Poor · Be unable to work, 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: Extreme muscle weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-05
Survey response — day 21, dose 2
MedDRA: Tachycardia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Tachycardia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-12
Survey response — day 28, dose 2
MedDRA: Tachycardia — 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: Tachycardia when standing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Survey response — day 35, dose 2
MedDRA: Tachycardia — Feeling: Poor · Be unable to work, 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: Tachycardia to 190s when standing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Survey response — day 42, dose 2
MedDRA: Postural orthostatic tachycardia syndrome — Feeling: Poor · Be unable to work, 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: POTS

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Survey response — 3 months, dose 2
MedDRA: Asthenia, Autonomic nervous system imbalance, Pre-existing disease, Vision blurred — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Long haul covid symptomsblurred vision weakness dyautonomia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-21
Call successful
Participant prefers to complete VAERS report online
2021-09-13
Survey response — 6 months, dose 2
MedDRA: Autonomic nervous system imbalance, Brain fog, Chest pain, Gait disturbance, Raynaud's phenomenon, Vision blurred — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dysautomia blurred vision brain fog raynauds chest pain difficulty walking

MedDRA releases: 2024-11 · check-in free text available
2021-09-13
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-14
Call 1 — Could Not Reach Participant
2021-09-17
Call 2 — Could Not Reach Participant
2022-03-15
Survey response — 12 months, dose 2
MedDRA: Ataxia, Brain fog, Fatigue, Headache, Histamine intolerance, Musculoskeletal stiffness, Neuropathy peripheral, Postural orthostatic tachycardia syndrome, Raynaud's phenomenon, Temperature regulation disorder, Temporomandibular pain and dysfunction syndrome, Thirst, Vision blurred — Feeling: Poor · Be unable to work or attend school

Free text: Pots histamine intolerance stiff neck occipital headaches blurred vision neuropathy fatigue ataxia tmj raynauds excessive thirst temperature instability brain fog

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-15	Moderna

Call center

7 call center cases

6 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — day 7, dose 2

2021-03-25

Systemic reaction (other): Numbness tingling in extremities

Release 6 — day 14, dose 2

2021-03-30

Symptoms: Extreme muscle weakness

Release 6 — day 21, dose 2

2021-04-05

Symptoms: Tachycardia

Release 7 — day 28, dose 2

2021-04-12

Symptoms: Tachycardia when standing

Release 7 — day 35, dose 2

2021-04-19

Symptoms: Tachycardia to 190s when standing

Release 8 — day 42, dose 2

2021-04-28

Symptoms: POTS

Release 9 — 3 months, dose 2

2021-06-14

Symptoms: Long haul covid symptomsblurred vision weakness dyautonomia

Release 9 — 6 months, dose 2

2021-09-13

Symptoms: Dysautomia blurred vision brain fog raynauds chest pain difficulty walking

Release 11 — 12 months, dose 2

2022-03-15

Symptoms: Pots histamine intolerance stiff neck occipital headaches blurred vision neuropathy fatigue ataxia tmj raynauds excessive thirst temperature instability brain fog

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
SD	Asthenia	✓	✓	✓
SD	Ataxia	·	·	✓
SD	Autonomic nervous system imbalance	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chest pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Gait disturbance	·	·	✓
SD	Headache	·	·	✓
SD	Histamine intolerance	·	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Postural orthostatic tachycardia syndrome	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Raynaud's phenomenon	·	·	✓
SD	Tachycardia	✓	✓	✓
SD	Temperature regulation disorder	·	·	✓
SD	Temporomandibular pain and dysfunction syndrome	·	·	✓
SD	Thirst	·	·	✓
SD	Vision blurred	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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