Y55-31311-79215

4 vaccinations 9 coded responses 21 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 229 / VA
Registered: 2021-03-26

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-26
Registered in v-safe
2021-03-27
Dose 1 — Moderna
2021-04-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: I have MCAS and have been more reactive this last week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 21, dose 1
MedDRA: Condition aggravated, Fatigue, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: More MCAS reactions & major flare that I cant calm down. Extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Dose 2 — Moderna
2021-04-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Brain fog, Dizziness, Feeling abnormal — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, balance issues, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Dizziness — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness & loss of balance.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Free text: Still a little dizzy & foggy headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-23
Survey response — 6 months, dose 2
MedDRA: Ageusia, Amnesia, Anosmia, Bone pain, Fatigue, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, loss of taste & smell, extreme fatigue, short term memory loss, bone pain. Covid test negative

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Dose 3 — Moderna
2022-04-15
Dose 4 — Moderna
2022-04-24
Survey response — 12 months, dose 2
MedDRA: Fatigue — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme fatigue more often than before

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — day 14, dose 4
MedDRA: Brain fog, Dizziness, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue dizziness brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — day 21, dose 4
MedDRA: Arthralgia, Brain fog, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue, brain fog, joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-17
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2021-11-08	Moderna	No
4	2022-04-15	Moderna	No

Free text

Release 7 — day 14, dose 1

2021-04-10

Symptoms: I have MCAS and have been more reactive this last week

Release 7 — day 21, dose 1

2021-04-17

Symptoms: More MCAS reactions & major flare that I cant calm down. Extreme fatigue

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): Dizzy, balance issues, brain fog

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Dizziness & loss of balance.

2021-04-27

Systemic reaction (other): Still a little dizzy & foggy headed

Release 10 — 6 months, dose 2

2021-10-23

Symptoms: Sore throat, loss of taste & smell, extreme fatigue, short term memory loss, bone pain. Covid test negative

Release 11 — 12 months, dose 2

2022-04-24

Symptoms: Extreme fatigue more often than before

Release 11 — day 14, dose 4

2022-05-01

Symptoms: Fatigue dizziness brain fog

Release 11 — day 21, dose 4

2022-05-06

Symptoms: Fatigue, brain fog, joint pain

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	Ageusia	·	·	✓
SD	Amnesia	·	·	✓
SD	Anosmia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Bone pain	·	·	✓
SD	Brain fog	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Balance disorder	✓	✓	✓
SRO	Brain fog	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	○

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