ZHL-29941-12188

2 vaccinations 6 coded responses 6 check-ins 6 free-text entries 6 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 384 / TN
Registered: 2021-05-19

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

2021-03-19
Dose 1 — Moderna
2021-04-20
Dose 2 — Moderna
2021-05-19
Registered in v-safe
2021-05-19
Survey response — day 28, dose 2
MedDRA: Brain fog, Diplopia, Dizziness, Pain in extremity, Rash erythematous, Tinnitus, Vertigo, Vomiting — 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: 1st shot just a sore arm 2nd shot a red rash on arm day or so later dissy throwing up to the point of iV vertigo spinning ears high pitch ring 24/7 still have it double vision brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-25
Survey response — day 35, dose 2
MedDRA: Asthenia, Deafness unilateral, Ear tube insertion, Tinnitus, Vertigo, Vision blurred — 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: Tennitus vertigo blurred vision cant hear put of right ear ears ringing 24/7 no energy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-01
Survey response — day 42, dose 2
MedDRA: Deafness, Fatigue, Nausea, Ocular hypertension, Tinnitus, Unevaluable event, Vertigo — 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: Tennitus vertigo nausea loss of hearing some sounds fatigue vision is stacked witb pressure i havent been able to drive sense april 23 · Healthcare visit (other): I have appointemwt with Ent the 2nd of june ans neroulogist the 22nd

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-12
Call 1 — Left Voicemail
2021-07-12
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-07-20
Survey response — 3 months, dose 2
MedDRA: Pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Stinging spots that come and go on my body but no sign of being stung by an insect · Healthcare visit (other): Had MRI and CTA

MedDRA releases: 2024-11 · check-in free text available
2021-07-20
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-24
Call 1 — Could Not Reach Participant
2021-07-29
Call 2 — Could Not Reach Participant
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Brain fog, Diplopia, Fatigue, Thyroid mass, Tinnitus, Vertigo — 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: Thyroid nodules removing thyroid the oct 18th still have tennitus double vision fatigue and brain fog vertigo comes ans goes

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-20
Survey response — 12 months, dose 2
MedDRA: Office visit, Thyroid mass, Thyroidectomy, Tinnitus, Vertigo, Visual impairment — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tinnitus (ear ringing) since last year 2nd C vaccine moderna had to have my thyroid removed after nodules got all over it on tyroid replacement meds still have vertigo and vision issues still no help about the vaccine issues · Healthcare visit (other): Doctors office and test

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-21
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-20	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-19	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-05-25	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-06-01	Successful 2021-07-12	Reported to VAERS voluntarily prior to GDIT contact
2021-07-20	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-10-19	Successful	Reported to VAERS voluntarily prior to GDIT contact
2022-04-20	Successful 2022-04-21	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 8 — day 28, dose 2

2021-05-19

Symptoms: 1st shot just a sore arm 2nd shot a red rash on arm day or so later dissy throwing up to the point of iV vertigo spinning ears high pitch ring 24/7 still have it double vision brain fog

Release 8 — day 35, dose 2

2021-05-25

Symptoms: Tennitus vertigo blurred vision cant hear put of right ear ears ringing 24/7 no energy

Release 8 — day 42, dose 2

2021-06-01

Symptoms: Tennitus vertigo nausea loss of hearing some sounds fatigue vision is stacked witb pressure i havent been able to drive sense april 23

Healthcare visit (other): I have appointemwt with Ent the 2nd of june ans neroulogist the 22nd

Release 9 — 3 months, dose 2

2021-07-20

Symptoms: Stinging spots that come and go on my body but no sign of being stung by an insect

Healthcare visit (other): Had MRI and CTA

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Thyroid nodules removing thyroid the oct 18th still have tennitus double vision fatigue and brain fog vertigo comes ans goes

Release 11 — 12 months, dose 2

2022-04-20

Symptoms: Tinnitus (ear ringing) since last year 2nd C vaccine moderna had to have my thyroid removed after nodules got all over it on tyroid replacement meds still have vertigo and vision issues still no help about the vaccine issues

Healthcare visit (other): Doctors office and test

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	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	✓	·	✓
SD	Brain fog	✓	✓	✓
SD	Deafness	✓	✓	✓
SD	Deafness unilateral	✓	·	✓
SD	Diplopia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Ear tube insertion	○	✓	○
SD	Fatigue	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Ocular hypertension	✓	✓	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Thyroid mass	·	·	✓
SD	Thyroidectomy	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Vertigo	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SD	Visual impairment	·	·	✓
SD	Vomiting	✓	✓	✓

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