YCL-22297-39449

5 vaccinations 17 coded responses 43 check-ins 15 free-text entries 8 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 761 / TX
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Survey response — day 0, dose 1
MedDRA: General symptom, Pre-existing disease — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: These are also typical symptoms for my autoimmune disorders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Have auto immune disorder and recovering from MVA, so symptoms are most likely from these. They were present prior to injection/vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: These are contributed to a MVA and autoimmune disorder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Due to MVA and underlying autoimmune disorders.

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: Autoimmune disorder, Pre-existing disease, Road traffic accident — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Normal due to MVA & autoimmune disorders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing spells

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-03-10
Survey response — day 28, dose 2
MedDRA: Back pain, Office visit, Pain in extremity, Pre-existing disease — Feeling: Fair · 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Low back, right leg/foot pain increased...injury related to MVA. · Healthcare visit (other): Orthopedic surgeon & Neurologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 28, 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)
2021-03-19
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-24
Survey response — day 42, dose 2
MedDRA: Back pain, Condition aggravated, Office visit, Pain in extremity, Pre-existing disease — Feeling: Fair · 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

Free text: Symptoms: Increased back, leg & foot pain...related to MVA · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 42, 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)
2021-05-14
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Call 1 — Left Voicemail
2021-08-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-15
Dose 3 — Moderna
2021-11-15
Health check-in — day 0, dose 3
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, 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: Still recovering from injuries sustained in a MVA in 2019

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-22
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-29
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-14
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-27
Survey response — day 42, dose 3
MedDRA: Ear pain, Fatigue, Oropharyngeal pain, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, ear ache, fatigue, achy

MedDRA releases: 2024-11 · check-in free text available
2022-02-14
Survey response — 3 months, dose 3
MedDRA: Respiratory disorder — Feeling: Poor · 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: Severe breathing issues

MedDRA releases: 2024-11 · check-in free text available
2022-02-14
Report sent to call center — 3 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)
2022-02-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-16
Dose 4 — Pfizer-BioNTech
2022-05-17
Survey response — 6 months, dose 3
MedDRA: Asthma, Fatigue, Respiratory disorder — Feeling: Poor · 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: Severe asthma - ongoing breathing issues and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Survey response — day 28, dose 4
MedDRA: Asthma, Dyspnoea, Fatigue, Pre-existing disease — Feeling: Poor · 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: Severe asthma - ongoing breathing issues with fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Report sent to call center — day 28, 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-17
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)
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-22
Health check-in — day 35, dose 4
Feeling: Poor

Adult check-in
2022-05-28
Health check-in — day 42, dose 4
Feeling: Poor

Adult check-in
2022-07-19
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-12-02
Dose 5 — Moderna
2023-04-19
Survey response — 12 months, dose 4
MedDRA: Asthma — 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

MedDRA releases: 2024-11
2023-04-19
Report sent to call center — 12 months, 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)
2023-04-20
Call 1 — Left Voicemail
2023-06-04
Survey response — 6 months, dose 5
MedDRA: Fall, Fatigue, Headache — Feeling: Poor · 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, Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-06-04
Call case (no matching report) — Successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-11-15	Moderna	No
4	2022-04-16	Pfizer-BioNTech	No
5	2022-12-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-16	priority 2/3
2021-03-10	Successful 2022-05-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-03-24	Successful 2022-05-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-14	Successful 2022-02-15	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-17	Successful 2022-05-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-17	Successful 2022-05-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-19	Successful 2023-06-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-04	Successful 2023-06-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — day 0, dose 1

2021-01-13

Systemic reaction (other): These are also typical symptoms for my autoimmune disorders.

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Have auto immune disorder and recovering from MVA, so symptoms are most likely from these. They were present prior to injection/vaccine.

2021-01-16

Systemic reaction (other): These are contributed to a MVA and autoimmune disorder

2021-01-17

Systemic reaction (other): Due to MVA and underlying autoimmune disorders.

2021-01-18

Systemic reaction (other): Normal due to MVA & autoimmune disorders.

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Coughing

2021-02-12

Systemic reaction (other): Cough

2021-02-15

Systemic reaction (other): Coughing spells

Release 5 — day 28, dose 2

2021-03-10

Symptoms: Low back, right leg/foot pain increased...injury related to MVA.

Healthcare visit (other): Orthopedic surgeon & Neurologist

Release 6 — day 42, dose 2

2021-03-24

Symptoms: Increased back, leg & foot pain...related to MVA

Healthcare visit (other): Office visit

Release 10 — days 1–6 daily, dose 3

2021-11-16

Systemic reaction (other): Still recovering from injuries sustained in a MVA in 2019

Release 10 — day 42, dose 3

2021-12-27

Symptoms: Sore throat, ear ache, fatigue, achy

Release 11 — 3 months, dose 3

2022-02-14

Symptoms: Severe breathing issues

Release 11 — 6 months, dose 3

2022-05-17

Symptoms: Severe asthma - ongoing breathing issues and fatigue

Release 11 — day 28, dose 4

2022-05-17

Symptoms: Severe asthma - ongoing breathing issues with fatigue

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
HCVO	Office visit	✓	✓	✓
SD	Asthma	·	·	✓
SD	Back pain	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Ear pain	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory disorder	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Autoimmune disorder	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	General symptom	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Road traffic accident	✓	✓	✓

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