XZY-31714-39678

2 vaccinations 16 coded responses 23 check-ins 16 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 605 / IL
Registered: 2021-04-09

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

Timeline

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Moderna
2021-04-09
Survey response — day 0, dose 1
MedDRA: Tinnitus — Feeling: Poor · Site: Pain · Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza like illness, Somnolence, Tinnitus — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tinnitus, it is so annoying! I feel like flue symptom! Sleepy!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Somnolence, Tinnitus — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tinnitus, sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal stiffness, Tinnitus — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Tinnitus is still on and off, stiff neck!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Tinnitus — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Tinnitus, dizzy,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Office visit, Tinnitus — Feeling: Fair · Chills, Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Tinnitus, tired · Healthcare visit (other): Met with PC

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Survey response — day 7, dose 1
MedDRA: Tinnitus — Feeling: Fair · Fatigue or tiredness

Free text: Tinnitus got stronger

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-30
Survey response — day 21, dose 1
MedDRA: Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tinnitus. Its increasing of the ringing sound in my left ear! I am panicking... what if it gets worse and worse!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Dose 2 — Moderna
2021-05-07
Survey response — day 0, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Itching

Free text: Tinnitus, ringing in both ears!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Tinnitus, it keeps ringing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising, Tinnitus — Feeling: Fair · Site: Redness, Itching

Free text: Tinnitus, bruise on my arm where the injection took place.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Redness, Itching

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Health check-in — day 21, dose 2
Feeling: Fair

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

Adult check-in
2021-06-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-02-23
Call 1 — Could Not Reach Participant
2022-02-28
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Moderna
2	2021-05-07	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-15	Successful 2022-02-28	Does not wish to fill out VAERS report

Free text

Release 7 — day 0, dose 1

2021-04-09

Systemic reaction (other): Tinnitus

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Tinnitus

2021-04-11

Systemic reaction (other): Tinnitus, it is so annoying! I feel like flue symptom! Sleepy!

2021-04-12

Systemic reaction (other): Tinnitus, sleepy

2021-04-13

Systemic reaction (other): Tinnitus is still on and off, stiff neck!

2021-04-14

Systemic reaction (other): Tinnitus, dizzy,

2021-04-15

Systemic reaction (other): Tinnitus, tired

Healthcare visit (other): Met with PC

Release 7 — day 7, dose 1

2021-04-16

Systemic reaction (other): Tinnitus got stronger

Release 8 — day 21, dose 1

2021-04-30

Symptoms: Tinnitus. Its increasing of the ringing sound in my left ear! I am panicking... what if it gets worse and worse!

Release 8 — day 0, dose 2

2021-05-07

Systemic reaction (other): Tinnitus, ringing in both ears!

Release 8 — days 1–6 daily, dose 2

2021-05-08

Systemic reaction (other): Tinnitus

2021-05-09

Systemic reaction (other): Tinnitus, it keeps ringing

2021-05-10

Systemic reaction (other): Tinnitus

2021-05-11

Systemic reaction (other): Tinnitus

2021-05-13

Systemic reaction (other): Tinnitus, bruise on my arm where the injection took place.

Release 8 — day 7, dose 2

2021-05-14

Systemic reaction (other): Tinnitus

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	Tinnitus	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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