YDT-43301-91755

2 vaccinations 7 coded responses 15 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 349 / FL
Registered: 2021-03-25

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

2021-03-25
Registered in v-safe
2021-03-25
Dose 1 — Moderna
2021-03-25
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-17
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-22
Dose 2 — Moderna
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Loss of consciousness — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Passed out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — days 1–6 daily, 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)
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Adult check-in
2021-04-25
Report sent to call center — days 1–6 daily, 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)
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of balance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 7, dose 2
Feeling: Fair · None

Adult check-in
2021-05-14
Survey response — day 21, dose 2
MedDRA: Pyrexia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — day 35, dose 2
MedDRA: Loss of consciousness — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of consciousness due to bad dental work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Survey response — day 42, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Due to negligent dental work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-22
Survey response — 3 months, dose 2
MedDRA: Arthropod bite, Emergency care, Injection site pain, Injection site pruritus, Self-medication — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Extreme painful itch at injection site. ER doctor prescribed steroids and benadryl with diagnosis of bug bite based on symptoms only. No sting or bite mark can be seen. That was 5 days ago. 5 days of steroids and benadryl have not alleviated symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-07-22
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-25
Call 1 — Left Voicemail
2021-10-26
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Sinusitis, Sneezing, Throat irritation — Feeling: Poor

Free text: Severe sinus infection, excessive sneezing, frequent throat irritation. Thought it was allergies, but I have never had allergy symptoms this severe continue this consistently and for so long. My 9 yr old son recently started experiencing similar symp

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-24	Unsuccessful
2021-04-25	Unsuccessful
2021-07-22	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): Passed out

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): Loss of balance

Release 8 — day 21, dose 2

2021-05-14

Symptoms: Fever

Release 8 — day 35, dose 2

2021-05-29

Symptoms: Loss of consciousness due to bad dental work

Release 8 — day 42, dose 2

2021-06-05

Symptoms: Due to negligent dental work

Release 9 — 3 months, dose 2

2021-07-22

Symptoms: Extreme painful itch at injection site. ER doctor prescribed steroids and benadryl with diagnosis of bug bite based on symptoms only. No sting or bite mark can be seen. That was 5 days ago. 5 days of steroids and benadryl have not alleviated symptoms cut off by CDC

Release 10 — 6 months, dose 2

2021-10-26

Symptoms: Severe sinus infection, excessive sneezing, frequent throat irritation. Thought it was allergies, but I have never had allergy symptoms this severe continue this consistently and for so long. My 9 yr old son recently started experiencing similar symp 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	Arthropod bite	·	·	✓
SD	Emergency care	·	·	✓
SD	Injection site pain	·	·	✓
SD	Injection site pruritus	·	·	✓
SD	Loss of consciousness	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Self-medication	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sneezing	·	·	✓
SD	Throat irritation	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓

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