YEV-81173-44399

3 vaccinations 15 coded responses 30 check-ins 15 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 338 / FL
Registered: 2021-01-26

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

2021-01-05
Dose 1 — Moderna
2021-01-26
Registered in v-safe
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Asthma — Feeling: Good

Free text: Asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — day 7, dose 2
MedDRA: Irritable bowel syndrome — Feeling: Good

Free text: IBSD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Nodule, Pancreatic failure, SARS-CoV-2 test — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shortness of breath, new cluster of nudules left base, not cancer. Covid test on May 10th. New dx pancreatic insufficiency.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Cough, Wheezing — Feeling: Fair

Free text: Wheezing upper airways and coughing.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-23
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Site: Itching

Free text: Sjogrens flare

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Wheezing and cough

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — day 7, dose 3
MedDRA: Cough, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Wheeze and cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — day 14, dose 3
MedDRA: Dyspnoea, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Wheezing and SOB

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — day 21, dose 3
MedDRA: Dyspnoea, Oxygen saturation decreased — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dyspnea, low 02 sats

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — day 28, dose 3
MedDRA: Dyspnoea exertional, Office visit, Wheezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Dyspnea, exertional and wheezes · Healthcare visit (other): Pulmonologist, rx steroid inhaler bid

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-27
Survey response — day 35, dose 3
MedDRA: Cough, Oxygen saturation decreased — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough, 02 sats 93-94

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Call 1 — Left Voicemail
2021-12-04
Survey response — day 42, dose 3
MedDRA: Cough, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Wheeze, 02 sat 90 this morning, cough, using nebulizer

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Survey response — 3 months, dose 3
MedDRA: Cough, Office visit, Pulmonary congestion — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cough and lung congestion · Healthcare visit (other): PCP appt

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-04-23
Survey response — 6 months, dose 3
MedDRA: Bronchiectasis, Chronic obstructive pulmonary disease, Hospitalisation, Oxygen therapy — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Hospitalized with copd and bronchiectasis, now on oxygen.

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-25
Call 1 — Left Voicemail
2022-04-26
Call 2 — Left Voicemail
2022-10-23
Survey response — 12 months, dose 3
MedDRA: Dyspnoea, Office visit, Oxygen saturation decreased, Wheezing — Feeling: Fair · 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: Symptoms: Shortness of breath,wheezing, low 02 sats. Need 02 2L n/c now with any activity. · Healthcare visit (other): Pulmonologist

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-26
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	2021-01-05	Moderna
2	2021-02-02	Moderna
3	2021-10-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-20	Successful 2022-10-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-22	Successful 2022-10-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-23	Successful 2022-10-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-23	Successful 2022-10-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Asthma

Release 3 — day 7, dose 2

2021-02-09

Systemic reaction (other): IBSD

Release 8 — 3 months, dose 2

2021-05-04

Symptoms: Shortness of breath, new cluster of nudules left base, not cancer. Covid test on May 10th. New dx pancreatic insufficiency.

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: Wheezing upper airways and coughing.

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Sjogrens flare

2021-10-29

Systemic reaction (other): Wheezing and cough

Release 10 — day 7, dose 3

2021-10-30

Systemic reaction (other): Wheeze and cough

Release 10 — day 14, dose 3

2021-11-06

Symptoms: Wheezing and SOB

Release 10 — day 21, dose 3

2021-11-13

Symptoms: Dyspnea, low 02 sats

Release 10 — day 28, dose 3

2021-11-20

Symptoms: Dyspnea, exertional and wheezes

Healthcare visit (other): Pulmonologist, rx steroid inhaler bid

Release 10 — day 35, dose 3

2021-11-27

Symptoms: Cough, 02 sats 93-94

Release 10 — day 42, dose 3

2021-12-04

Symptoms: Wheeze, 02 sat 90 this morning, cough, using nebulizer

Release 11 — 3 months, dose 3

2022-01-22

Symptoms: Cough and lung congestion

Healthcare visit (other): PCP appt

Release 11 — 6 months, dose 3

2022-04-23

Symptoms: Hospitalized with copd and bronchiectasis, now on oxygen.

Release 12 — 12 months, dose 3

2022-10-23

Symptoms: Shortness of breath,wheezing, low 02 sats. Need 02 2L n/c now with any activity.

Healthcare visit (other): Pulmonologist

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	Bronchiectasis	·	·	✓
SD	Chronic obstructive pulmonary disease	·	·	✓
SD	Cough	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Dyspnoea exertional	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Nodule	✓	✓	✓
SD	Oxygen saturation decreased	·	·	✓
SD	Oxygen therapy	·	·	✓
SD	Pancreatic failure	✓	✓	✓
SD	Pulmonary congestion	·	·	✓
SD	SARS-CoV-2 test	✓	✓	✓
SD	Wheezing	✓	·	✓
SRO	Asthma	✓	✓	✓
SRO	Condition aggravated	·	·	✓
SRO	Cough	·	·	✓
SRO	Irritable bowel syndrome	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Wheezing	·	·	✓

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