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ZG2-16043-62571

1 vaccination 6 coded responses 9 check-ins 6 free-text entries 2 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
916 / CA
Registered
2021-02-24
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-17
    Dose 1 — Moderna
  2. 2021-02-24
    Registered in v-safe
  3. 2021-02-24
    Survey response — day 7, dose 1
    MedDRA: Headache — Feeling: Poor · Fever · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Had a bad headache in the night
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-04
    Health check-in — day 14, dose 1
    Feeling: Poor
    Adult check-in
  5. 2021-03-10
    Survey response — day 21, dose 1
    MedDRA: Chronic fatigue syndrome, Condition aggravated, Fatigue, Feeling abnormal, Flushing, Immune system disorder, Pre-existing disease, Unevaluable event — Feeling: Poor · 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: Symptoms: I have longtime CFS the vaccine has set off an intense immune response Im at an all time fatigue with some flushing,BP problems and brain fog .no real fever or soar throat or head cold. Its a nightmare .. thank you · Healthcare visit (other): I will see my heart dr tomorrow
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-10
    Report sent to call center — day 21, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  7. 2021-03-17
    Survey response — day 28, dose 1
    MedDRA: Flushing, Hypertension, Hypoaesthesia — Feeling: Poor · Be unable to do your normal daily activities
    Free text: The face flushing,fatigue,high bp continues.Ive never had this condition. My heart dr says my heart is very good.blood work ok . Recently both my feet went numbish,probably from the constant flush an bp.. magnesium helps
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-24
    Survey response — day 35, dose 1
    MedDRA: Flushing, Hypertension, Hypoaesthesia, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities
    Free text: My foot numbness an pain was diagnosed from a EMG to be Axonal Polyneuropathy CIAP.Im not diabetic,alcoholic.it is progressing up my legs. I need answers.I also still have face flush and constant high bp thank you
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-03
    Survey response — day 42, dose 1
    MedDRA: Asthenia, Flushing, Neuropathy peripheral — Feeling: Poor · Be unable to do your normal daily activities
    Free text: The neuropathy is n the arms also now .. the overwhelming lack of endurance, face flushing continues.pretty much the same since February 19 ..something I cant control .also my BP which my I do have is on a repeat cycle ..which is not normal for me
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-20
    Health check-in — 3 months, dose 1
    Feeling: Poor
    Adult check-in
  11. 2021-08-18
    Survey response — 6 months, dose 1
    MedDRA: Aura, Migraine, Mobility decreased, Neuropathy peripheral, Pre-existing disease, Vision blurred, Visual impairment — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit
    Free text: The neuropathy has moved further up my legs.migraines are new ..I had a aurora visual n my right eye ..blurry with odd colors.Im still house bound.all the other conditions still remain . no dr cares because the vacinne is perfectly safe,please
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  12. 2021-08-18
    Report sent to call center — 6 months, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-08-20
  14. 2022-02-19
    Health check-in — 12 months, dose 1
    Feeling: Poor
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-17Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-03-10 Unsuccessful
2021-08-18 Unsuccessful

Free text

Release 4 — day 7, dose 1

2021-02-24

Systemic reaction (other): Had a bad headache in the night

Release 5 — day 21, dose 1

2021-03-10

Symptoms: I have longtime CFS the vaccine has set off an intense immune response Im at an all time fatigue with some flushing,BP problems and brain fog .no real fever or soar throat or head cold. Its a nightmare .. thank you
Healthcare visit (other): I will see my heart dr tomorrow

Release 5 — day 28, dose 1

2021-03-17

Symptoms: The face flushing,fatigue,high bp continues.Ive never had this condition. My heart dr says my heart is very good.blood work ok . Recently both my feet went numbish,probably from the constant flush an bp.. magnesium helps

Release 6 — day 35, dose 1

2021-03-24

Symptoms: My foot numbness an pain was diagnosed from a EMG to be Axonal Polyneuropathy CIAP.Im not diabetic,alcoholic.it is progressing up my legs. I need answers.I also still have face flush and constant high bp thank you

Release 6 — day 42, dose 1

2021-04-03

Symptoms: The neuropathy is n the arms also now .. the overwhelming lack of endurance, face flushing continues.pretty much the same since February 19 ..something I cant control .also my BP which my I do have is on a repeat cycle ..which is not normal for me

Release 9 — 6 months, dose 1

2021-08-18

Symptoms: The neuropathy has moved further up my legs.migraines are new ..I had a aurora visual n my right eye ..blurry with odd colors.Im still house bound.all the other conditions still remain . no dr cares because the vacinne is perfectly safe,please

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDAura ✓ · ✓
SDChronic fatigue syndrome ✓ ✓ ✓
SDCondition aggravated ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDFeeling abnormal ✓ ✓ ✓
SDFlushing ✓ ✓ ✓
SDHypertension ✓ ✓ ✓
SDHypoaesthesia ✓ ✓ ✓
SDImmune system disorder ✓ ✓ ✓
SDMigraine ✓ · ✓
SDMobility decreased ✓ · ✓
SDNeuropathy peripheral ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDVision blurred ✓ · ✓
SDVisual impairment ✓ · ✓
SROHeadache ✓ ✓ ✓

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