ZU5-26398-18626

4 vaccinations 17 coded responses 35 check-ins 16 free-text entries 5 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 240 / VA
Registered: 2021-01-12

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Moderna
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Good · Site: Pain · Headache

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Good · Site: Pain · Headache

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Survey response — day 0, dose 2
MedDRA: Dizziness, Vision blurred — Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Free text: Dizzy and lightheaded for about 3 hours post injection and blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Fast heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Diarrhea

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Chest pain — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Mild chest discomfort/pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Nausea

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred — Feeling: Good

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · Nausea

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Chills, Feeling cold, Vaccine positive rechallenge — Feeling: Fair

Free text: I keep getting chills, similar to the ones that hit right after the second dose. They are not all the time, much like after shocks. But they feel exactly like the chills I got from the shot side effects. They keep me colder than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 35, dose 2
MedDRA: Rash, Rash pruritic — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I developed an itchy, bumpy rash on my face, neck and chest suddenly on 3/9/21. No known cause. Had to take steroids to help resolve. Still lingering rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Survey response — day 42, dose 2
MedDRA: Chills, Migraine — Feeling: Good · Be unable to work

Free text: Migraines have increased. Have on going chills similar to the vaccines side effect.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-29
Call 1 — Left Voicemail
2021-12-03
Dose 3 — Moderna
2022-10-07
Dose 4 — Moderna
2022-10-10
Survey response — days 1–6 daily, dose 4
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pins and needles in extremities

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Survey response — days 1–6 daily, dose 4
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pins and needles shocks throughout body

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Survey response — days 1–6 daily, dose 4
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Pins and needles shocks through body

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Survey response — days 1–6 daily, dose 4
MedDRA: Electric shock sensation, Paraesthesia — Feeling: Good · Fatigue or tiredness, Abdominal pain

Free text: Pins and needles shocks throughout body

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Survey response — day 7, dose 4
MedDRA: Electric shock sensation, Pain, Paraesthesia — Feeling: Good · Fatigue or tiredness, Abdominal pain

Free text: Pins and needles shooting electrical shots through body

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-11
Survey response — day 35, dose 4
MedDRA: Ageusia, Anosmia, Chest discomfort, Cough, Fatigue, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion — Feeling: Fair · 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

Free text: Sore throat, cough, congestion, fever, body aches, loss of smell/taste, fatigue, chest pressure

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Report sent to call center — day 35, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-15
Call 2 — Left Voicemail
2022-11-15
Call 1 — Left Voicemail
2022-11-15
Call successful
Does not wish to fill out VAERS report
2022-11-15
Call successful
Does not wish to fill out VAERS report
2022-11-18
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-06
Survey response — 3 months, dose 4
MedDRA: Balance disorder, COVID-19, Cognitive disorder, Fatigue, Gastrointestinal disorder, Headache, Pre-existing disease, Vertigo, Vision blurred — 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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-06
Report sent to call center — 3 months, dose 4
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 · 1 call case(s)
2023-01-09
Call successful
Not applicable - Accidental Reporting
2023-04-07
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-12-03	Moderna	No
4	2022-10-07	Moderna	No

Call center

5 call center cases

3 successful · 2 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Blurry vision

2021-01-18

Systemic reaction (other): Blurry vision

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): Dizzy and lightheaded for about 3 hours post injection and blurry vision

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Fast heart rate

2021-02-11

Systemic reaction (other): Blurry vision

2021-02-13

Systemic reaction (other): Mild chest discomfort/pain

2021-02-15

Systemic reaction (other): Blurry vision

Release 5 — day 28, dose 2

2021-03-09

Symptoms: I keep getting chills, similar to the ones that hit right after the second dose. They are not all the time, much like after shocks. But they feel exactly like the chills I got from the shot side effects. They keep me colder than usual.

Release 5 — day 35, dose 2

2021-03-16

Symptoms: I developed an itchy, bumpy rash on my face, neck and chest suddenly on 3/9/21. No known cause. Had to take steroids to help resolve. Still lingering rash.

Release 6 — day 42, dose 2

2021-03-23

Symptoms: Migraines have increased. Have on going chills similar to the vaccines side effect.

Release 12 — days 1–6 daily, dose 4

2022-10-10

Systemic reaction (other): Pins and needles in extremities

2022-10-11

Systemic reaction (other): Pins and needles shocks throughout body

2022-10-12

Systemic reaction (other): Pins and needles shocks through body

2022-10-13

Systemic reaction (other): Pins and needles shocks throughout body

Release 12 — day 7, dose 4

2022-10-14

Systemic reaction (other): Pins and needles shooting electrical shots through body

Release 12 — day 35, dose 4

2022-11-11

Symptoms: Sore throat, cough, congestion, fever, body aches, loss of smell/taste, fatigue, chest pressure

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Balance disorder	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chills	✓	✓	✓
SD	Cognitive disorder	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling cold	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Migraine	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Vaccine positive rechallenge	✓	✓	✓
SD	Vertigo	·	·	✓
SD	Vision blurred	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Electric shock sensation	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Paraesthesia	·	·	✓
SRO	Vision blurred	✓	✓	✓

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