YFU-14251-04596

4 vaccinations 10 coded responses 37 check-ins 9 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 218 / MD
Registered: 2021-02-01

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

2021-01-30
Dose 1 — Moderna
2021-02-01
Registered in v-safe
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Fair · Nausea, Diarrhea

Adult check-in
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Injection site pain — Feeling: Good · Site: Itching

Free text: In the first 24 hours after the second shot, I had chills and my body was very tired. The arm was tender at the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Headache, Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: Headache, diarrhea, nausea for about four days.

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Dose 4 — Moderna
2022-04-25
Survey response — 6 months, dose 3
MedDRA: Pericarditis, Pulmonary hypertension — 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: Pulmonary Hypertension Paracardem inflammation

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
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)
2022-04-26
Call 1 — Left Voicemail
2022-05-18
Survey response — day 28, dose 4
MedDRA: Asthma, Hospitalisation, Pericarditis, Pulmonary hypertension — 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, Hospitalization

Free text: Two times in the hospital Pulmonary Hypertension Inflammation in Pericardium Asthma

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Report sent to call center — day 28, dose 4
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)
2022-05-19
Call 2 — Left Voicemail
2022-05-19
Call 1 — Left Voicemail
2022-05-24
Survey response — day 35, dose 4
MedDRA: Hospitalisation, Surgery — 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: Hospital surgical

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Report sent to call center — day 35, dose 4
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)
2022-05-25
Call 1 — Left Voicemail
2022-05-31
Survey response — day 42, dose 4
MedDRA: Blood pressure increased, Dyspnoea, Fluid retention — Feeling: Poor · 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: Short of breath Fluid retention Elevated B/P

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Report sent to call center — day 42, dose 4
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)
2022-06-01
Call successful
Participant prefers to complete VAERS report online
2022-06-01
Call successful
Participant prefers to complete VAERS report online
2022-06-01
Call successful
Participant prefers to complete VAERS report online
2022-06-01
Call successful
Participant prefers to complete VAERS report online
2022-07-19
Survey response — 3 months, dose 4
MedDRA: Hospitalisation, Pneumonia, Pulmonary oedema — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Hospitalized with fluid around my lungs. Also, pneumonia

MedDRA releases: 2024-11 · check-in free text available
2022-07-19
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-07-20
Call 2 — Left Voicemail
2022-10-18
Survey response — 6 months, dose 4
MedDRA: Adverse reaction, Hospitalisation, Malaise, Office visit, Pericarditis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hospitalized four times after the second booster! Sick for 3 months. I developed pericarditis two days after the shot. All three of the doctors I had said it was more than likely caused by the shot. I still take a lot of meds because of it.

MedDRA releases: 2024-11 · check-in free text available
2023-04-19
Survey response — 12 months, dose 4
MedDRA: Hospitalisation, Reaction to previous exposure to any vaccine, Unevaluable event — 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, Hospitalization

MedDRA releases: 2024-11
2023-04-19
Report sent to call center — 12 months, dose 4
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)
2023-04-20
Call 1 — Left Voicemail
2023-04-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-03-03	Moderna
3	2021-10-25	Moderna	No
4	2022-04-19	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-25	Successful 2022-06-01	Participant prefers to complete VAERS report online
2022-05-18	Successful 2022-06-01	Participant prefers to complete VAERS report online
2022-05-24	Successful 2022-06-01	Participant prefers to complete VAERS report online
2022-05-31	Successful 2022-06-01	Participant prefers to complete VAERS report online
2022-07-19	Unsuccessful
2023-04-19	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): In the first 24 hours after the second shot, I had chills and my body was very tired. The arm was tender at the injection site.

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): Light headed

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Headache, diarrhea, nausea for about four days.

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: Pulmonary Hypertension Paracardem inflammation

Release 11 — day 28, dose 4

2022-05-18

Symptoms: Two times in the hospital Pulmonary Hypertension Inflammation in Pericardium Asthma

Release 11 — day 35, dose 4

2022-05-24

Symptoms: Hospital surgical

Release 11 — day 42, dose 4

2022-05-31

Symptoms: Short of breath Fluid retention Elevated B/P

Release 12 — 3 months, dose 4

2022-07-19

Symptoms: Hospitalized with fluid around my lungs. Also, pneumonia

Release 12 — 6 months, dose 4

2022-10-18

Symptoms: Hospitalized four times after the second booster! Sick for 3 months. I developed pericarditis two days after the shot. All three of the doctors I had said it was more than likely caused by the shot. I still take a lot of meds because of it.

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	Adverse reaction	·	·	✓
SD	Asthma	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fluid retention	·	·	✓
SD	Headache	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Office visit	·	·	✓
SD	Pericarditis	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pulmonary hypertension	·	·	✓
SD	Pulmonary oedema	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Surgery	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site pain	✓	✓	✓

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