YDY-18675-43126

2 vaccinations 9 coded responses 28 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 26-30
ZIP prefix: 770 / TX
Registered: 2021-01-23

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

2021-01-23
Registered in v-safe
2021-01-23
Dose 1 — Moderna
2021-01-23
Health check-in — day 0, dose 1
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Redness, Swelling

Free text: Non verbal but seems pain free

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Redness, Swelling

Free text: Non verbal but seems okay

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder — Feeling: Good

Free text: Lost Sense of balance for a short time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety — Feeling: Fair

Free text: May not be related but he has been agitated and full of anxiety today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Energy increased, Nervous system disorder — Feeling: Good

Free text: May not be related but was having neurological trouble yesterday that caused him to hit himself and lots of energy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Pre-existing disease — Feeling: Fair

Free text: This is a nonverbal man with autism who is experiencing much anxiety since a day after being vaccinated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Is hitting himself sometimes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Seizure — Feeling: Good · Be unable to do your normal daily activities

Free text: I had not had a seizure in years, but had one on Friday August 20. And lots of anxiety.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-03-03
Survey response — 12 months, dose 2
MedDRA: Anxiety, Head injury, Office visit, Pre-existing disease — Feeling: Fair · 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: Esteban's character is mild mannered and compliant. He has been full of anxiety lately off and on lately. We are adjusting prescriptions to help him calm down because he is non verbal. · Healthcare visit (other): Psychiatrist in person visit because of hitting his head progressively more and more but now he just has anxiety

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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-07
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna
2	2021-03-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-03-03	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-25

Systemic reaction (other): Non verbal but seems pain free

2021-01-26

Systemic reaction (other): Non verbal but seems okay

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Lost Sense of balance for a short time

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): May not be related but he has been agitated and full of anxiety today.

2021-03-06

Systemic reaction (other): May not be related but was having neurological trouble yesterday that caused him to hit himself and lots of energy.

2021-03-07

Systemic reaction (other): This is a nonverbal man with autism who is experiencing much anxiety since a day after being vaccinated

Release 5 — day 7, dose 2

2021-03-10

Systemic reaction (other): Is hitting himself sometimes

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: I had not had a seizure in years, but had one on Friday August 20. And lots of anxiety.

Release 11 — 12 months, dose 2

2022-03-03

Symptoms: Esteban's character is mild mannered and compliant. He has been full of anxiety lately off and on lately. We are adjusting prescriptions to help him calm down because he is non verbal.

Healthcare visit (other): Psychiatrist in person visit because of hitting his head progressively more and more but now he just has anxiety

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	Anxiety	·	·	✓
HCVO	Head injury	·	·	✓
HCVO	Office visit	·	·	✓
SD	Anxiety	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Seizure	✓	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Energy increased	✓	✓	✓
SRO	Nervous system disorder	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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