ZJU-53077-31431

2 vaccinations 24 coded responses 24 check-ins 24 free-text entries 2 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 871 / NM
Registered: 2021-05-28

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

2021-05-27
Dose 1 — Moderna
2021-05-28
Registered in v-safe
2021-05-28
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Dizziness — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: dizziness, brainfog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Dizziness, Feeling hot — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: dizziness, brainfog, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: dizziness, brainfog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Dizziness — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: dizziness, brainfog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Dizziness, Feeling hot — 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: dizziness, brainfog, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 7, dose 1
MedDRA: Brain fog, Dizziness, Feeling hot — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: dizziness, brainfog, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — day 14, dose 1
MedDRA: Brain fog, Fatigue, Nausea, Pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: achiness, fatigue, fever, brainfog, nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Survey response — day 21, dose 1
MedDRA: Asthenia, Body temperature increased, Dysphagia, Facial pain, Fatigue, Feeling hot, Headache, Malaise, Nausea, Oropharyngeal pain, Pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Worsening respiratory symptoms, sore throat, severe head and facial pain, headache, severe fatigue, weakness, full-body pain, malaise, dizziness, nausea, feeling very hot, extremely sore throat with difficulty swallowing, hectic fever (99.9 - 101.9)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — day 28, dose 1
MedDRA: Asthenia, Dizziness, Fatigue, Nausea, Pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe weakness, fatigue, full-body achiness, and dizziness, erratic fever, nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Survey response — day 35, dose 1
MedDRA: Asthenia, Fatigue, Malaise, Nausea, Pain — Feeling: Poor · Be unable to work or attend school

Free text: Severe fatigue, weakness, achiness, malaise, occasional nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-04
Dose 2 — Moderna
2021-07-05
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Dizziness, Feeling hot, Heart rate increased — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Rapid heartrate, feeling very hot, dizziness, weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness, Feeling hot — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: brainfog, dizziness, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness, Feeling hot — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: brainfog, dizziness, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Brain fog, Dizziness, Feeling hot — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: brainfog, dizziness, weakness, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Brain fog, Dizziness, Feeling hot — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: brainfog, dizziness, weakness, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Brain fog, Dizziness, Feeling hot — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: brainfog, dizziness, weakness, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Survey response — day 7, dose 2
MedDRA: Asthenia, Brain fog, Dizziness, Feeling hot — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: brainfog, weakness, dizziness, feeling very hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-18
Survey response — day 14, dose 2
MedDRA: Dizziness, Fatigue, Nausea, Pain, Pyrexia, Somnolence — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe fatigue, sleepiness, achiness, nausea, intermittent fever, dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-07-25
Survey response — day 21, dose 2
MedDRA: Chills, Dizziness, Fatigue, Feeling hot, Headache, Malaise, Nausea, Pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Intermittent fever, severe achiness, fatigue, malaise, and dizziness, chills, feeling very hot, frequent headaches, nausea

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-01
Survey response — day 28, dose 2
MedDRA: Asthenia, Dizziness, Fatigue, Nausea, Pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe achiness, weakness, fatigue, and dizziness, nausea, intermittent fever

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-08
Survey response — day 35, dose 2
MedDRA: Asthenia, Condition aggravated, Dizziness, Fatigue, Nausea, Pain, Pre-existing disease, Pyrexia, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Increasingly severe weakness, fatigue, achiness, and dizziness, ongoing intermittent fever, exacerbated IBD, worsening, more frequent nausea, inexplicable, repeated vomiting episodes on night of 8/7/21

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
Survey response — day 42, dose 2
MedDRA: Asthenia, Blood pressure increased, Chills, Fatigue, Feeling hot, Hypertension, Irritable bowel syndrome, Nausea, Office visit, Pain, Palpitations, Pre-existing disease, Pyrexia, Tachycardia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Ongoing intermittent fever, severe weakness, achiness, and fatigue, nausea, chills, feeling very hot, exacerbation of already-existing severe IBD, increasing elevation of blood pressure (I already have hypertension), severe tachycardia, palpitations · Healthcare visit (other): Crucial appointment with cardiologist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
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)
2021-08-25
Call 1 — Left Voicemail
2021-10-06
Survey response — 3 months, dose 2
MedDRA: Asthenia, Dizziness, Dysphagia, Fatigue, Oedema, Office visit, Pain, Pyrexia, Skin discolouration, Tachycardia — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe edema and purple discoloration of legs, ankles, and feet, ongoing hectic fever since late May, ongoing chronic dizziness, fatigue, and weakness, difficulty swallowing, tachycardia, severe, full-body achiness · Healthcare visit (other): appointment with cardiologist

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-07
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-27	Moderna
2	2021-07-04	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-18	Unsuccessful
2021-10-06	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 1

2021-05-28

Systemic reaction (other): dizziness

2021-05-29

Systemic reaction (other): dizziness, brainfog

2021-05-30

Systemic reaction (other): dizziness, brainfog, feeling very hot

2021-05-31

Systemic reaction (other): dizziness, brainfog

2021-06-01

Systemic reaction (other): dizziness, brainfog

2021-06-02

Systemic reaction (other): dizziness, brainfog, feeling very hot

Release 8 — day 7, dose 1

2021-06-03

Systemic reaction (other): dizziness, brainfog, feeling very hot

Release 9 — day 14, dose 1

2021-06-10

Symptoms: achiness, fatigue, fever, brainfog, nausea

Release 9 — day 21, dose 1

2021-06-17

Symptoms: Worsening respiratory symptoms, sore throat, severe head and facial pain, headache, severe fatigue, weakness, full-body pain, malaise, dizziness, nausea, feeling very hot, extremely sore throat with difficulty swallowing, hectic fever (99.9 - 101.9) cut off by CDC

Release 9 — day 28, dose 1

2021-06-24

Symptoms: Severe weakness, fatigue, full-body achiness, and dizziness, erratic fever, nausea

Release 9 — day 35, dose 1

2021-07-02

Symptoms: Severe fatigue, weakness, achiness, malaise, occasional nausea

Release 9 — days 1–6 daily, dose 2

2021-07-05

Systemic reaction (other): Rapid heartrate, feeling very hot, dizziness, weakness

2021-07-06

Systemic reaction (other): brainfog, dizziness, feeling very hot

2021-07-07

Systemic reaction (other): brainfog, dizziness, feeling very hot

2021-07-08

Systemic reaction (other): brainfog, dizziness, weakness, feeling very hot

2021-07-09

Systemic reaction (other): brainfog, dizziness, weakness, feeling very hot

2021-07-10

Systemic reaction (other): brainfog, dizziness, weakness, feeling very hot

Release 9 — day 7, dose 2

2021-07-11

Systemic reaction (other): brainfog, weakness, dizziness, feeling very hot

Release 9 — day 14, dose 2

2021-07-18

Symptoms: Severe fatigue, sleepiness, achiness, nausea, intermittent fever, dizziness

Release 9 — day 21, dose 2

2021-07-25

Symptoms: Intermittent fever, severe achiness, fatigue, malaise, and dizziness, chills, feeling very hot, frequent headaches, nausea

Release 9 — day 28, dose 2

2021-08-01

Symptoms: Severe achiness, weakness, fatigue, and dizziness, nausea, intermittent fever

Release 9 — day 35, dose 2

2021-08-08

Symptoms: Increasingly severe weakness, fatigue, achiness, and dizziness, ongoing intermittent fever, exacerbated IBD, worsening, more frequent nausea, inexplicable, repeated vomiting episodes on night of 8/7/21

Release 9 — day 42, dose 2

2021-08-18

Symptoms: Ongoing intermittent fever, severe weakness, achiness, and fatigue, nausea, chills, feeling very hot, exacerbation of already-existing severe IBD, increasing elevation of blood pressure (I already have hypertension), severe tachycardia, palpitations cut off by CDC

Healthcare visit (other): Crucial appointment with cardiologist

Release 10 — 3 months, dose 2

2021-10-06

Symptoms: Severe edema and purple discoloration of legs, ankles, and feet, ongoing hectic fever since late May, ongoing chronic dizziness, fatigue, and weakness, difficulty swallowing, tachycardia, severe, full-body achiness

Healthcare visit (other): appointment with cardiologist

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	Asthenia	✓	✓	✓
SD	Blood pressure increased	✓	·	✓
SD	Body temperature increased	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Chills	✓	·	✓
SD	Condition aggravated	✓	·	✓
SD	Dizziness	✓	✓	✓
SD	Dysphagia	✓	✓	✓
SD	Facial pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypertension	✓	·	✓
SD	Irritable bowel syndrome	✓	·	✓
SD	Malaise	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oedema	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Palpitations	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Skin discolouration	·	·	✓
SD	Somnolence	·	·	✓
SD	Tachycardia	✓	·	✓
SD	Vomiting	✓	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Brain fog	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓

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