YAS-74108-04831

3 vaccinations 6 coded responses 13 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 921 / CA
Registered: 2021-02-01

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2020-12-30
Dose 1 — Moderna
2021-02-01
Registered in v-safe
2021-02-01
Dose 2 — Moderna
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Headache, Hypoaesthesia, Injected limb mobility decreased, Insomnia, Nausea, Pain, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: The night of injection lack of sleep, severe body pains, numbness down arms into fingers, chills, fever, nausea, headache, unable to move injected arm for a day, extreme fatigue

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

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain upper, Chest pain, Decreased appetite, Eructation — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Stomach pain into chest, keep having to burp, no appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 7, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Headache, Muscle or body aches, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-02-08
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-15
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-15
Survey response — day 42, dose 2
MedDRA: Arthralgia, Asthenia, Gastrooesophageal reflux disease, Nausea — Feeling: Fair

Free text: Bouts of nausea, reflux, on & off shoulder pain and weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-19
Call successful
Completed over the phone
2021-12-30
Dose 3 — Moderna
2022-02-01
Survey response — 12 months, dose 2
MedDRA: Abdominal pain upper, Cold sweat, Diarrhoea, Feeling hot, Headache, Hyperhidrosis, Wheezing — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Hot & cold sweats but no fever, headache on & on, wheezing, stomach pains with diarrhea on & off

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Survey response — day 42, dose 3
MedDRA: Cough, Decreased appetite, Diarrhoea, Nausea, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had severe nausea and diarrhea for 3 days with loss of appetite now doing a little better today, more of a on & off cough and wheezing

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Survey response — 6 months, dose 3
MedDRA: Cold sweat, Cough, Diarrhoea, Dizziness, Dyspnoea exertional, Fatigue, Feeling hot, Headache, Hot flush, Hyperhidrosis, Migraine, Pain, Productive cough, Visual impairment, Weight increased, Wheezing — 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, Outpatient clinic or urgent care clinic visit

Free text: Consistent cough, diarrhea or very loose bowel with urination, fatigue, weight gain, wheezing, phlegm, hot & cold sweats & flashes, dizziness, headache or more often migraines, body aches, vision changes, some shortness of breath especially with move

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Report sent to call center — 6 months, dose 3
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-05
Call 1 — Requested Callback
2022-07-05
Call 1 — Requested Callback
2022-07-05
Callback requested for
05:00PM ET
2022-07-05
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-02-01	Moderna
3	2021-12-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-08	Successful 2021-07-19	Completed over the phone
2022-07-01	Successful 2022-07-05	Completed over the phone

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): The night of injection lack of sleep, severe body pains, numbness down arms into fingers, chills, fever, nausea, headache, unable to move injected arm for a day, extreme fatigue

2021-02-07

Systemic reaction (other): Stomach pain into chest, keep having to burp, no appetite

Release 5 — day 42, dose 2

2021-03-15

Symptoms: Bouts of nausea, reflux, on & off shoulder pain and weakness

Release 11 — 12 months, dose 2

2022-02-01

Symptoms: Hot & cold sweats but no fever, headache on & on, wheezing, stomach pains with diarrhea on & off

Release 11 — day 42, dose 3

2022-02-10

Symptoms: Had severe nausea and diarrhea for 3 days with loss of appetite now doing a little better today, more of a on & off cough and wheezing

Release 12 — 6 months, dose 3

2022-07-01

Symptoms: Consistent cough, diarrhea or very loose bowel with urination, fatigue, weight gain, wheezing, phlegm, hot & cold sweats & flashes, dizziness, headache or more often migraines, body aches, vision changes, some shortness of breath especially with move cut off by CDC

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	Abdominal pain upper	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Cold sweat	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling hot	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Headache	·	·	✓
SD	Hot flush	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Migraine	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	·	·	✓
SD	Productive cough	·	·	✓
SD	Visual impairment	·	·	✓
SD	Weight increased	·	·	✓
SD	Wheezing	·	·	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Eructation	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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