YCH-17720-94975

4 vaccinations 9 coded responses 24 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 674 / KS
Registered: 2021-03-05

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

2021-02-04
Dose 1 — Moderna
2021-03-03
Dose 2 — Moderna
2021-03-05
Registered in v-safe
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Chronic obstructive pulmonary disease, Pre-existing disease — Feeling: Good · Diarrhea

Free text: I feel pretty good today. I have severe COPD and I was surprised that my lungs were not affected at all.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — day 14, dose 2
MedDRA: Chronic obstructive pulmonary disease, Pre-existing disease — Feeling: Good · 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: Flare of my COPD. Doctor put me on steroids and Zpac.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Survey response — day 21, dose 2
MedDRA: Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Survey response — day 42, dose 2
MedDRA: Abdominal discomfort, Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shortness of breath and bowel issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2022-03-04
Call successful
Participant prefers to complete VAERS report online
2022-03-05
Survey response — 12 months, dose 2
MedDRA: Blood pressure increased, Condition aggravated, Depression, Dyspnoea, Heart rate increased, Pre-existing disease — Feeling: Fair · 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: 2 more flares of COPD, 2 more rounds of antibiotics and steroids (Shortness of breath with increased heart rate and high blood pressure) and more depression). People refusing to wear masks and mixed messages from politicians is toxic.

MedDRA releases: 2024-11 · check-in free text available
2022-03-05
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-29
Dose 4 — Moderna
2022-05-04
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site cellulitis — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Developed cellulitis right below injection site on arm

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-06
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · Abdominal pain

Adult check-in
2022-05-13
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-27
Survey response — day 28, dose 4
MedDRA: Cough, Fatigue, Oropharyngeal pain, Pulmonary congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Congestion in lungs, some coughing, mild sore throat, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-29
Survey response — 6 months, dose 4
MedDRA: Dyspnoea, Type 2 diabetes mellitus, Weight decreased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diagnosed with Type 2 diabetes. More shortness of breath. (But I lost 19 pounds)

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call successful
Does not wish to fill out VAERS report
2022-11-03
Callback requested for
10:00AM ET
2023-04-29
Survey response — 12 months, dose 4
MedDRA: Tinnitus — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-03	Moderna
3	2021-10-28	Moderna	No
4	2022-04-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-17	Successful 2022-03-04	Participant prefers to complete VAERS report online
2022-03-05	Successful	Participant prefers to complete VAERS report online
2022-05-04	Successful 2022-05-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-29	Successful 2022-10-31	Does not wish to fill out VAERS report

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): I feel pretty good today. I have severe COPD and I was surprised that my lungs were not affected at all.

Release 5 — day 14, dose 2

2021-03-17

Symptoms: Flare of my COPD. Doctor put me on steroids and Zpac.

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Shortness of breath.

Release 7 — day 42, dose 2

2021-04-16

Symptoms: Shortness of breath and bowel issues.

Release 11 — 12 months, dose 2

2022-03-05

Symptoms: 2 more flares of COPD, 2 more rounds of antibiotics and steroids (Shortness of breath with increased heart rate and high blood pressure) and more depression). People refusing to wear masks and mixed messages from politicians is toxic.

Release 11 — days 1–6 daily, dose 4

2022-05-04

Systemic reaction (other): Developed cellulitis right below injection site on arm

Release 11 — day 28, dose 4

2022-05-27

Symptoms: Congestion in lungs, some coughing, mild sore throat, fatigue

Release 12 — 6 months, dose 4

2022-10-29

Symptoms: Diagnosed with Type 2 diabetes. More shortness of breath. (But I lost 19 pounds)

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 discomfort	✓	✓	✓
SD	Blood pressure increased	·	·	✓
SD	Chronic obstructive pulmonary disease	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Depression	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pulmonary congestion	·	·	✓
SD	Tinnitus	·	·	✓
SD	Type 2 diabetes mellitus	·	·	✓
SD	Weight decreased	·	·	✓
SRO	Chronic obstructive pulmonary disease	✓	✓	✓
SRO	Injection site cellulitis	·	·	✓
SRO	Pre-existing disease	✓	✓	✓

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