YEU-16642-17089

3 vaccinations 16 coded responses 28 check-ins 16 free-text entries 5 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 948 / CA
Registered: 2021-03-15

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

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Moderna
2021-03-15
Health check-in — day 0, dose 1
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Systemic lupus erythematosus — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: I do have lupus so that could be the cause of some the issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Abdominal pain

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-29
Survey response — day 14, dose 1
MedDRA: Erythema, Injection site erythema, Injection site mass, Injection site pruritus, Pruritus, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: Crazy itching, redness, and still a lump in my arm at injection site (every vaccine I've ever had makes a big lump that lasts for weeks.) Itching started last night (3/28/21.)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-12
Survey response — day 0, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Severe migraine but had it before shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Still have the stinking migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Same damned migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Migraine — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Going to cut my head off if this migraine doesn't get better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Same damned migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — day 7, dose 2
MedDRA: Migraine — Feeling: Poor · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Friggin migraine won't end

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Poor

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Survey response — day 35, dose 2
MedDRA: Cystitis — Feeling: Good

Free text: The ever popular bladder infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Good

Free text: Same headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Atrial fibrillation, Oedema, Renal impairment — Feeling: Poor · 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

Free text: A-fib, decreased kidney function, severe edema

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Report sent to call center — 6 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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2022-04-14
Survey response — 12 months, dose 2
MedDRA: 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, Emergency room or emergency department visit, Hospitalization

Free text: Left heart failure, Right heart failure, PAH, Bergers Disease.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-17
Dose 3 — Moderna
2022-06-22
Survey response — day 35, dose 3
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Bi- valvular heart failure, PAH, kidney failure (Bergers disease), osteoporosis

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-28
Survey response — day 42, dose 3
MedDRA: Cardiac failure, IgA nephropathy, Pulmonary arterial hypertension, Renal failure — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Bi-valvular heart failure, PAH, Bergers disease (kidney failure). NOT RELATED TO VACCINE

MedDRA releases: 2024-11 · check-in free text available
2022-06-28
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-06-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-16
Survey response — 3 months, dose 3
MedDRA: Unevaluable event — 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, Outpatient clinic or urgent care clinic visit

Free text: Possible lung cancer. Waiting on confirmation of tests.

MedDRA releases: 2024-11 · check-in free text available
2022-08-16
Report sent to call center — 3 months, dose 3
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 · 1 call case(s)
2022-08-19
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	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2022-05-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-11	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-14	Successful 2022-04-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-22	Successful 2022-06-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-28	Successful 2022-06-29	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-16	Successful 2022-08-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): I do have lupus so that could be the cause of some the issues.

Release 6 — day 14, dose 1

2021-03-29

Symptoms: Crazy itching, redness, and still a lump in my arm at injection site (every vaccine I've ever had makes a big lump that lasts for weeks.) Itching started last night (3/28/21.)

Release 7 — day 0, dose 2

2021-04-12

Systemic reaction (other): Severe migraine but had it before shot.

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Migraine

2021-04-14

Systemic reaction (other): Still have the stinking migraine

2021-04-15

Systemic reaction (other): Same damned migraine

2021-04-16

Systemic reaction (other): Going to cut my head off if this migraine doesn't get better

2021-04-17

Systemic reaction (other): Same damned migraine

Release 7 — day 7, dose 2

2021-04-19

Systemic reaction (other): Friggin migraine won't end

Release 8 — day 35, dose 2

2021-05-17

Symptoms: The ever popular bladder infection.

Release 8 — day 42, dose 2

2021-05-24

Symptoms: Same headache

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: A-fib, decreased kidney function, severe edema

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: Left heart failure, Right heart failure, PAH, Bergers Disease.

Release 12 — day 35, dose 3

2022-06-22

Symptoms: Bi- valvular heart failure, PAH, kidney failure (Bergers disease), osteoporosis

Release 12 — day 42, dose 3

2022-06-28

Symptoms: Bi-valvular heart failure, PAH, Bergers disease (kidney failure). NOT RELATED TO VACCINE

Release 12 — 3 months, dose 3

2022-08-16

Symptoms: Possible lung cancer. Waiting on confirmation of tests.

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	Atrial fibrillation	·	·	✓
SD	Cardiac failure	·	·	✓
SD	Cystitis	✓	✓	✓
SD	Erythema	✓	✓	○
SD	Headache	✓	✓	✓
SD	IgA nephropathy	·	·	✓
SD	Injection site erythema	·	·	✓
SD	Injection site mass	✓	✓	✓
SD	Injection site pruritus	·	·	✓
SD	Oedema	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	○
SD	Pulmonary arterial hypertension	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Renal failure	·	·	✓
SD	Renal impairment	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Systemic lupus erythematosus	✓	✓	✓

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