Y5V-11775-17546

2 vaccinations 10 coded responses 26 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 925 / CA
Registered: 2021-02-02

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

2021-02-02
Registered in v-safe
2021-02-02
Dose 1 — Moderna
2021-02-02
Survey response — day 0, dose 1
MedDRA: Feeling abnormal — Feeling: Good · Fatigue or tiredness

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Itching · Muscle or body aches

Free text: Dizzy if I look up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-23
Survey response — day 21, dose 1
MedDRA: Dizziness postural — Feeling: Good

Free text: Dizziness when lying down or getting up. Happened at dentist and occasionally at home since vaccination, briefly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Dose 2 — Moderna
2021-03-02
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Dizziness when looking up or when lying down.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness postural — Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild dizziness when looking up or lying down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain fog, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: A bit of dizziness when lying down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 21, dose 2
MedDRA: Sciatica — 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: Sciatica

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-31
Survey response — 6 months, dose 2
MedDRA: Brain fog — Feeling: Good

Free text: Brain fog

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-03-02
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal disorder, Headache, Upper-airway cough syndrome — Feeling: Good · Be unable to do your normal daily activities

Free text: End of January I had digestive tract symptoms, headache, post nasal drip, and other symptoms which my children thought was omicron.

MedDRA releases: 2024-11 · check-in free text available
2022-03-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

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

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Successful 2022-03-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — day 0, dose 1

2021-02-02

Systemic reaction (other): Brain fog

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Dizzy if I look up

Release 4 — day 21, dose 1

2021-02-23

Symptoms: Dizziness when lying down or getting up. Happened at dentist and occasionally at home since vaccination, briefly.

Release 4 — day 0, dose 2

2021-03-02

Systemic reaction (other): Dizziness when looking up or when lying down.

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Mild dizziness when looking up or lying down

2021-03-04

Systemic reaction (other): Brain fog, dizziness

2021-03-07

Systemic reaction (other): A bit of dizziness when lying down

Release 6 — day 21, dose 2

2021-03-23

Symptoms: Sciatica

Release 9 — 6 months, dose 2

2021-08-31

Symptoms: Brain fog

Release 11 — 12 months, dose 2

2022-03-02

Symptoms: End of January I had digestive tract symptoms, headache, post nasal drip, and other symptoms which my children thought was omicron.

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	Brain fog	✓	·	✓
SD	Dizziness postural	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Sciatica	✓	✓	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dizziness postural	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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