Y2Y-18140-26719

2 vaccinations 7 coded responses 14 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 627 / IL
Registered: 2021-06-11

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

2021-06-09
Dose 1 — Moderna
2021-06-11
Registered in v-safe
2021-06-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-06-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Nausea

Adult check-in
2021-06-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-06-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-06-16
Survey response — day 7, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Edema in feet but happens on occasions with my COPD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — day 14, dose 1
MedDRA: Dyspnoea, Pre-existing disease — Feeling: Fair

Free text: Stage 4 COPD and having horrible day trrying to breathe today. Im assuming its because of COPD. I have good days and bad days with breathing all the time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Survey response — day 28, dose 1
MedDRA: Bursitis, Cellulitis, Chronic obstructive pulmonary disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Been in hospital with COPD exacerbation and cellulitis in my feet and bursitis in my elbow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Report sent to call center — day 28, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-09
Dose 2 — Moderna
2021-07-13
Call 1 — Left Voicemail
2021-07-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-21
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Adult check-in
2021-07-21
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Survey response — day 14, dose 2
MedDRA: Brain fog, Confusional state, Grip strength decreased, Muscle twitching, Tremor — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Twitching in hands causing me to drop items in hands a lot, hand tremors, and brain fog or feeling like my head is in tbe clouds ans putting me in state of confusion.l

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-27
Call 1 — Left Voicemail
2021-07-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Call 2 — Left Voicemail
2021-08-07
Survey response — day 28, dose 2
MedDRA: Bursitis, Condition aggravated, Hospitalisation, Oedema peripheral, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Fighting edema in feet and ankles, bursitis in right elbow, and symtoms of COPD exacerbation at this point in time that required hospitalization again.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-16
Survey response — day 35, dose 2
MedDRA: Bursitis, Oedema peripheral, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Edema in both feet, nursitis in right elbow, COPD issues

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-16
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Call 1 — Left Voicemail
2021-08-22
Survey response — day 42, dose 2
MedDRA: Bursitis, Condition aggravated, Oedema, Pneumonia, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Pneumonia, edema, bursitis, and COPD exacerbation.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-22
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Call 1 — Left Voicemail
2021-10-13
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-09	Moderna
2	2021-07-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-07	Successful 2021-07-18	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-21	Unsuccessful
2021-07-23	Unsuccessful
2021-08-07	Unsuccessful
2021-08-16	Unsuccessful
2021-08-22	Unsuccessful

Free text

Release 9 — day 7, dose 1

2021-06-16

Systemic reaction (other): Edema in feet but happens on occasions with my COPD

Release 9 — day 14, dose 1

2021-06-24

Symptoms: Stage 4 COPD and having horrible day trrying to breathe today. Im assuming its because of COPD. I have good days and bad days with breathing all the time.

Release 9 — day 28, dose 1

2021-07-07

Symptoms: Been in hospital with COPD exacerbation and cellulitis in my feet and bursitis in my elbow.

Release 9 — day 14, dose 2

2021-07-23

Symptoms: Twitching in hands causing me to drop items in hands a lot, hand tremors, and brain fog or feeling like my head is in tbe clouds ans putting me in state of confusion.l

Release 9 — day 28, dose 2

2021-08-07

Symptoms: Fighting edema in feet and ankles, bursitis in right elbow, and symtoms of COPD exacerbation at this point in time that required hospitalization again.

Release 9 — day 35, dose 2

2021-08-16

Symptoms: Edema in both feet, nursitis in right elbow, COPD issues

Release 9 — day 42, dose 2

2021-08-22

Symptoms: Pneumonia, edema, bursitis, and COPD exacerbation.

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	Brain fog	✓	·	✓
SD	Bursitis	✓	✓	✓
SD	Cellulitis	✓	✓	✓
SD	Chronic obstructive pulmonary disease	✓	✓	✓
SD	Condition aggravated	✓	·	✓
SD	Confusional state	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Grip strength decreased	✓	·	✓
SD	Hospitalisation	✓	·	✓
SD	Muscle twitching	✓	·	✓
SD	Oedema	✓	·	✓
SD	Oedema peripheral	✓	·	✓
SD	Pneumonia	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Tremor	✓	·	✓
SRO	Pre-existing disease	✓	✓	✓

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