ZC8-65052-07849

3 vaccinations 13 coded responses 20 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 378 / TN
Registered: 2021-04-10

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

2021-03-12
Dose 1 — Moderna
2021-04-09
Dose 2 — Moderna
2021-04-10
Registered in v-safe
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Restlessness, Tremor — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Severe dizziness, restlessness, SEVERE shakiness (almost convulsions)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Agitation, Dizziness, Restlessness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Still feeling extremely restless and agitated. Dizziness is still present.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Confusion, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain, Peripheral swelling — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Throbbing pain in my injection site arm, towards my elbow. It's swollen and very painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-23
Survey response — day 14, dose 2
MedDRA: Abdominal pain, Diarrhoea, Feeling abnormal, Migraine, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe abdominal pain with diarrhea and nausea, migraine, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Survey response — 3 months, dose 2
MedDRA: Amnesia, Balance disorder, Blindness, Chills, Confusional state, Coordination abnormal, Dizziness, Heart rate increased, Hyperhidrosis, Migraine, Pyrexia, Syncope — 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: fever, chills, hot sweats, neurological problems including blackout migraines, loss of balance, loss of coordination, dizziness, fainting, racing heartbeat, vision loss, memory loss, severe confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
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)
2021-07-23
Call successful
Participant prefers to complete VAERS report online
2021-10-14
Survey response — 6 months, dose 2
MedDRA: Amnesia, Confusional state, Coordination abnormal, Electric shock sensation, Fall, Fatigue, Insomnia, Limb discomfort, Migraine, Muscular weakness, Musculoskeletal stiffness, Office visit, Pain, Pain in extremity, Palpitations — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: loss of coordination in legs, weakness, heaviness, stiffness in legs & arms, severe confusion, memory loss, migraines, worsening heart palps, throbbing/ electric sensations in legs, sleeplessness, extreme fatigue, falling down · Healthcare visit (other): 2 appointments: nurse practitioner &GP

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-21
Call 1 — Could Not Reach Participant
2021-10-26
Dose 3 — Pfizer-BioNTech
2021-10-26
Call 2 — Could Not Reach Participant
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Balance disorder, Vision blurred — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: blurred vision, lack of equilibrium

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Balance disorder, Coordination abnormal, Cough, Discomfort, Hypoaesthesia, Limb discomfort, Oropharyngeal pain, Paraesthesia, Vision blurred — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sore throat, dry persistent cough, lack of coordination/equilibrium, blurred vision, neck/legs/arms feel like lead, tingling numbness in hands/feet

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — day 7, dose 3
MedDRA: Brain fog, Confusional state, Coordination abnormal, Dizziness, Vision blurred — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Confusion, dizzy, foggy, blurred vision, lack of coordination

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-16
Survey response — day 21, dose 3
MedDRA: Coordination abnormal, Limb discomfort, Migraine, Musculoskeletal stiffness, Pain in extremity, Rash, Rash erythematous, Systemic lupus erythematosus rash, Vision blurred — Feeling: Fair · Be unable to do your normal daily activities

Free text: Red lupus type rash on face, reallyyyy stiff/heavy/uncoordinated legs and stiff painfully arms, migraines, blurred vision

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Survey response — day 28, dose 3
MedDRA: Amnesia, Brain fog, Confusional state, Dyspnoea, Dyspnoea exertional, Fatigue, Loss of personal independence in daily activities, Pain, Pain in extremity, Vision blurred — Feeling: Poor · Be unable to do your normal daily activities

Free text: Worsening shortness of breath, even after easy activities. Total exhaustion: unable to do basic self-care like showering or cooking/eating. Very painful legs and arms. Sore all over. EXTREME brain fog, confusion, memory loss, blurred vision.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Confusional state, Cough, Dizziness, Dysphagia, Fatigue, Insomnia, Migraine, Myalgia, Oropharyngeal pain, Sinus congestion, Vision blurred, Wheezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore throat, cough, sinus congestion, migraine for the last 14+ days, blurred vision, dizziness, confusion, difficulty swallowing, wheezing, muscle and joint pain, SEVERE exhaustion, insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-09	Moderna
3	2021-10-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-11	Successful 2021-07-23	Participant prefers to complete VAERS report online
2021-10-14	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Severe dizziness, restlessness, SEVERE shakiness (almost convulsions)

2021-04-11

Systemic reaction (other): Still feeling extremely restless and agitated. Dizziness is still present.

2021-04-12

Systemic reaction (other): Confusion, dizziness

2021-04-15

Systemic reaction (other): Throbbing pain in my injection site arm, towards my elbow. It's swollen and very painful.

Release 7 — day 14, dose 2

2021-04-23

Symptoms: Severe abdominal pain with diarrhea and nausea, migraine, brain fog

Release 9 — 3 months, dose 2

2021-07-11

Symptoms: fever, chills, hot sweats, neurological problems including blackout migraines, loss of balance, loss of coordination, dizziness, fainting, racing heartbeat, vision loss, memory loss, severe confusion

Release 10 — 6 months, dose 2

2021-10-14

Symptoms: loss of coordination in legs, weakness, heaviness, stiffness in legs & arms, severe confusion, memory loss, migraines, worsening heart palps, throbbing/ electric sensations in legs, sleeplessness, extreme fatigue, falling down

Healthcare visit (other): 2 appointments: nurse practitioner &GP

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): blurred vision, lack of equilibrium

2021-11-01

Systemic reaction (other): Sore throat, dry persistent cough, lack of coordination/equilibrium, blurred vision, neck/legs/arms feel like lead, tingling numbness in hands/feet

Release 10 — day 7, dose 3

2021-11-02

Systemic reaction (other): Confusion, dizzy, foggy, blurred vision, lack of coordination

Release 10 — day 21, dose 3

2021-11-16

Symptoms: Red lupus type rash on face, reallyyyy stiff/heavy/uncoordinated legs and stiff painfully arms, migraines, blurred vision

Release 10 — day 28, dose 3

2021-11-23

Symptoms: Worsening shortness of breath, even after easy activities. Total exhaustion: unable to do basic self-care like showering or cooking/eating. Very painful legs and arms. Sore all over. EXTREME brain fog, confusion, memory loss, blurred vision.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Sore throat, cough, sinus congestion, migraine for the last 14+ days, blurred vision, dizziness, confusion, difficulty swallowing, wheezing, muscle and joint pain, SEVERE exhaustion, insomnia

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	Abdominal pain	✓	✓	✓
SD	Amnesia	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Balance disorder	✓	✓	✓
SD	Blindness	✓	✓	✓
SD	Brain fog	○	○	✓
SD	Chills	✓	✓	✓
SD	Confusional state	✓	✓	✓
SD	Coordination abnormal	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dysphagia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Electric shock sensation	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	○	○	○
SD	Heart rate increased	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Limb discomfort	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Migraine	✓	✓	✓
SD	Muscular weakness	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Palpitations	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	·	·	✓
SD	Rash erythematous	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Syncope	✓	✓	✓
SD	Systemic lupus erythematosus rash	·	·	✓
SD	Vision blurred	·	·	✓
SD	Wheezing	·	·	✓
SRO	Agitation	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Balance disorder	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Confusional state	✓	✓	✓
SRO	Coordination abnormal	·	·	✓
SRO	Cough	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Limb discomfort	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Restlessness	✓	✓	✓
SRO	Tremor	✓	✓	✓
SRO	Vision blurred	·	·	✓

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