B9T-51780-34004

2 vaccinations 16 coded responses 17 check-ins 14 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 270 / NC
Registered: 2022-09-16

Relationship: Adult relative or friend
Guardian: XND-35683-94179
Race: American Indian or Alaska Native
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2022-09-15
Dose 1 — Moderna
2022-09-16
Registered in v-safe
2022-09-16
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Fair · Site: Redness, Swelling

MedDRA releases: 2024-11 · check-in answers available
2022-09-18
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Hyperhidrosis — Feeling: Good · Site: Pain, Swelling

MedDRA releases: 2024-11 · check-in answers available
2022-09-22
Survey response — 7 day, dose 1, dependent
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-09-22
Report sent to call center — 7 day, dose 1, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-23
Call successful
Does not wish to fill out VAERS report
2022-09-29
Survey response — 14 day, dose 1, dependent
MedDRA: Condition aggravated, Dyspnoea, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-09-29
Report sent to call center — 14 day, dose 1, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-30
Call successful
Participant prefers to complete VAERS report online
2022-10-07
Survey response — 21 day, dose 1, dependent
MedDRA: COVID-19, Cough, Dementia, Diarrhoea, Gastrointestinal disorder, Pre-existing disease — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-10-15
Survey response — 28 day, dose 1, dependent
MedDRA: Abulia, Cardiac disorder, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Gait disturbance, Mobility decreased, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-10-15
Report sent to call center — 28 day, dose 1, dependent
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-18
Call successful
Does not wish to fill out VAERS report
2022-10-20
Dose 2 — Moderna
2022-10-20
Survey response — 35 day, dose 1, dependent
MedDRA: Condition aggravated, Mobility decreased, Office visit, Pre-existing disease — Feeling: Poor · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-10-20
Report sent to call center — 35 day, dose 1, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-21
Call 1 — Could Not Reach Participant
2022-10-22
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Cough, Increased upper airway secretion, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Poor · Site: Pain · Fever · Chills, Nausea

MedDRA releases: 2024-11 · check-in answers available
2022-10-23
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: COVID-19, Diarrhoea — Feeling: Poor · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-10-26
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Asthenia, Cardiac failure congestive, Medical counselling, Myasthenia gravis, Pre-existing disease — Feeling: Good · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-10-26
Report sent to call center — days 1–6 daily, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-26
Call 2 — Could Not Reach Participant
2022-10-27
Health check-in — 7 day, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-10-27
Call successful
Does not wish to fill out VAERS report
2022-10-27
Call successful
Does not wish to fill out VAERS report
2022-11-04
Survey response — 14 day, dose 2, dependent
MedDRA: Memory impairment — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-11-11
Survey response — 21 day, dose 2, dependent
MedDRA: Thirst — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-11-19
Survey response — 28 day, dose 2, dependent
MedDRA: Nausea, Tremor, Vomiting — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-11-24
Survey response — 35 day, dose 2, dependent
MedDRA: Dysstasia, Gait disturbance, Loss of personal independence in daily activities, Myasthenia gravis, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-01-19
Survey response — 3 month, dose 2, dependent
MedDRA: COVID-19, Confusional state, Decreased appetite, Dehydration, Fluid intake reduced, Muscular weakness, Myasthenia gravis, Neuropathy peripheral, Office visit, Pre-existing disease, Tremor, Weight decreased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2023-01-19
Report sent to call center — 3 month, dose 2, dependent
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-20
Call 1 — Left Voicemail
2023-04-20
Survey response — 6 month, dose 2, dependent
MedDRA: Cardiac failure congestive, Dyspnoea, General physical health deterioration, Heart rate decreased, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2023-04-20
Report sent to call center — 6 month, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-21
Call 2 — Left Voicemail
2023-04-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-09-15	Moderna	No
2	2022-10-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-22	Successful 2022-09-23	Does not wish to fill out VAERS report
2022-09-29	Successful 2022-09-30	Participant prefers to complete VAERS report online
2022-10-15	Successful 2022-10-18	Does not wish to fill out VAERS report
2022-10-20	Successful 2022-10-27	Does not wish to fill out VAERS report
2022-10-26	Successful 2022-10-27	Does not wish to fill out VAERS report
2023-01-19	Unsuccessful
2023-04-20	Unsuccessful

Free text

Release 12

Systemic reaction (other): Alotbof sneezing,congestion runny nose but no fever or temp.

Systemic reaction (other): Her legs are leaving sheets pretty damp when she gets up.

Systemic reaction (other): Her dementia WAS in early stages but seems to have progressed

Healthcare visit (other): Appt is mon. Had to reschedule fom yesterday til mon.due to issues with our dog. Had to put her down today

Symptoms: Her CHF breathing seems worse. She's more out of breath sooner.

Healthcare visit (other): Office visit for an echocardiogram..no results for @wk

Symptoms: Loose bowels again( but only 1 mudslide so far. Dk.if this is vaccine or just more long covid. She had bicious bowel issues with covid in may. She is starting to cough some(dry).seems like such a jump in her dementia( doesn't know how to do things) cut off by CDC

Symptoms: But i dk if its vaccine or not. Her heart is much worse. Her Aortic Valve went from 26 to 49! on the echo.test.She can now only take 3 or4 steps be4 sitting/heavy breathing.Rt knee is worse.Almost drags her ft. Can't make either this or that decision cut off by CDC

Healthcare visit (other): Visit to cardiologist& testing

Symptoms: Her CHF is worse. She WAS able to go 9 steps from bed to table.Now she is barely able to go the 3 steps from BSC to bed.Idk if this is vaccines fault for sure,but it seems unusual that her CHF would just happen to get worse NOW.

Healthcare visit (other): Saw her cardio.She has gone from class 1 to class 3 in CHF. They want her to have surgery on her aortic valve

Systemic reaction (other): Sneezing increased congestion,runny nose,mild cough,more phlegm in throat. It"s like she got a flu shot!

Systemic reaction (other): Her stools r liquid now like they were in May when she had covid. I'm thinking for people this age only 1 shot is advisable + the booster just released. Their system just can't take it. ESPECIALLY if they're less than 5'

Systemic reaction (other): Weakness is much worse after this shot. I thiught it was her CHF but it's not. The shot HAS made THAT worse but the worsening weakness is her myasthenia gravis getting worse. The weakness is severe

Healthcare visit (other): FNP came to the house to follow up on heart & told me the weakness that's severe is her myasthenia gravis is MUCH worse

Symptoms: There seems to be episodes of forgetfulness now & more confusion. She completely forgot sitting up all nite to wait on a bm so she wouldn't soil her pull up at nite again( THAT was new!).She had never slept thru a bm be4. Now she forgets how she trie cut off by CDC

Symptoms: She seems to have excessive thirst( but NOT excessive urination). We got her flu shot exactly 2wks after her 2nd shot. No one seemed to have a definitive answer for how long to wait,except evryone DID say i've heard at least 2 wks. Did we mess up?

Symptoms: We're back to daily mudslides & nausea . Last night she threw up. Did i tell u about her rt hand tremors? That's been going on@ a mth now. Did NOT take her to dr due to my OWN severe issues

Symptoms: Her myasthenia gravis has progressed markedly in her legs.She can't stand long enuf for me to clean back of her thighs/buttocksShe starts sitting on my arm stretched across to the far arm of bsc.Increasingly difficult to get into car.Can only walk9 s cut off by CDC

Free-text releases are not linked to a specific 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	Asthenia	·	·	✓
HCVO	Condition aggravated	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Myasthenia gravis	·	·	✓
HCVO	Neuropathy peripheral	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Pre-existing disease	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abulia	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Cardiac failure congestive	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Confusional state	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Dehydration	·	·	✓
SD	Dementia	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Dysstasia	·	·	✓
SD	Echocardiogram abnormal	·	·	✓
SD	Fluid intake reduced	·	·	✓
SD	Gait disturbance	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	General physical health deterioration	·	·	✓
SD	Heart rate decreased	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Memory impairment	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Myasthenia gravis	·	·	✓
SD	Nausea	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Thirst	·	·	✓
SD	Tremor	·	·	✓
SD	Vomiting	·	·	✓
SD	Weight decreased	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Cardiac failure congestive	·	·	✓
SRO	Cough	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Increased upper airway secretion	·	·	✓
SRO	Myasthenia gravis	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sneezing	·	·	✓
SRO	Unevaluable event	·	·	✓

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