YGA-26157-88569

4 vaccinations 12 coded responses 41 check-ins 11 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 190 / PA
Registered: 2021-02-18

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

2021-02-16
Dose 1 — Moderna
2021-02-18
Registered in v-safe
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-02-23
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-03-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-16
Dose 2 — Moderna
2021-03-16
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperglycaemia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Hyperglycemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperglycaemia — Feeling: Fair · Fever · Chills, Fatigue or tiredness

Free text: Hyperglycemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperglycaemia — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Hyperglycemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperglycaemia — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Hyperglycemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 7, dose 2
MedDRA: Office visit — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Medical office visit yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — day 14, dose 2
MedDRA: Balance disorder, Fatigue, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Unsteadiness when walking. Greater fatigue. · Healthcare visit (other): Medical office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-13
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-27
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-15
Survey response — 3 months, dose 2
MedDRA: Dizziness, Dyskinesia, Headache, Immunisation reaction, Mastication disorder, Mobility decreased, Neck pain, Pain, Trismus — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Developed severe headache with severe back of neck pain. Unable to turn head, pain on chewing. Unable to fully open mouth. Unable to move due to pain and lightheaded. Severe pain treated with Predisone for 10 days. Felt to be reaction to 2nd Moderna

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-21
Call 2 — Left Voicemail
2021-09-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-30
Dose 3 — Moderna
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Headache, Neck pain, Pain — Feeling: Fair · Headache, Muscle or body aches

Free text: Neck pain radiating to back of head with headache.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain, Headache, Neck pain — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Intense pain across upper back, up my neck to right side of head.

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Neuropathy peripheral, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Neuropathy in hands and feet. · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-01
Call 1 — Left Voicemail
2022-03-31
Dose 4 — Moderna
2022-04-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-28
Survey response — day 28, dose 4
MedDRA: Arthralgia, Eye pain, Headache, Neck pain, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headache and pulsing Pain from neck up to behind left eye and from neck to throat and left shoulder. This is the same pain I had post COVID vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-03-31
Survey response — 12 months, dose 4
MedDRA: Pulmonary hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-31
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-04
Call 1 — Left Voicemail
2023-04-04
Call 1 — Left Voicemail
2023-04-04
Call 1 — Left Voicemail
2023-04-04
Call 2 — Left Voicemail
2023-04-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Moderna
2	2021-03-16	Moderna
3	2021-10-30	Moderna	No
4	2022-03-31	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Unsuccessful
2021-03-30	Unsuccessful
2021-06-15	Unsuccessful
2022-01-29	Unsuccessful
2023-03-31	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): Hyperglycemia

2021-03-19

Systemic reaction (other): Hyperglycemia

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Hyperglycemia

2021-03-21

Systemic reaction (other): Hyperglycemia

Release 6 — day 7, dose 2

2021-03-23

Healthcare visit (other): Medical office visit yesterday

Release 6 — day 14, dose 2

2021-03-30

Symptoms: Unsteadiness when walking. Greater fatigue.

Healthcare visit (other): Medical office

Release 9 — 3 months, dose 2

2021-06-15

Symptoms: Developed severe headache with severe back of neck pain. Unable to turn head, pain on chewing. Unable to fully open mouth. Unable to move due to pain and lightheaded. Severe pain treated with Predisone for 10 days. Felt to be reaction to 2nd Moderna cut off by CDC

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): Neck pain radiating to back of head with headache.

2021-11-05

Systemic reaction (other): Intense pain across upper back, up my neck to right side of head.

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Neuropathy in hands and feet.

Healthcare visit (other): Office visit

Release 11 — day 28, dose 4

2022-04-28

Symptoms: Headache and pulsing Pain from neck up to behind left eye and from neck to throat and left shoulder. This is the same pain I had post COVID vaccine.

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	Arthralgia	·	·	✓
SD	Balance disorder	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyskinesia	✓	·	✓
SD	Eye pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Immunisation reaction	✓	·	✓
SD	Mastication disorder	✓	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Neuropathy peripheral	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pulmonary hypertension	·	·	✓
SD	Trismus	○	✓	○
SRO	Back pain	·	·	✓
SRO	Headache	·	·	✓
SRO	Hyperglycaemia	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Pain	·	·	✓

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