YGB-15447-26608

5 vaccinations 11 coded responses 55 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 911 / CA
Registered: 2021-01-12

Relationship: Self
Race: Other
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-07
Dose 1 — Moderna
2021-01-12
Registered in v-safe
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Joint pains

Free text: Short of breath Int

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Int SOB. Started 1/8 now subsiding

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dyspnoea — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Light headed. Short of breath probably due to broncos

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: SOB. SOBE

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dyspnoea — Feeling: Fair · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: SOB some md intermittent chest tightness probanle bronchospam

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Tremor — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Shakinwss. SOB. Inteemittent.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-31
Dose 3 — Moderna
2021-10-31
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Hallucination — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Free text: Hallucinated once

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-11-07
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness

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

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

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

Adult check-in
2021-12-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-30
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Pfizer-BioNTech
2022-04-08
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-09
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2022-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-12
Survey response — days 1–6 daily, dose 4
MedDRA: Bradyphrenia, Brain fog, Dissociation — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Disconnected. Thinking slow. Making small errors that i would nornally not do. Brain foggy

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Survey response — days 1–6 daily, dose 4
MedDRA: Disturbance in attention, Fatigue — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Fatigue difficulty concentrating

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Survey response — days 1–6 daily, dose 4
MedDRA: Disturbance in attention — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Inability to concentrate well.

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-20
Survey response — day 42, dose 4
MedDRA: Headache, Visual impairment — Feeling: Good · Be unable to do your normal daily activities

Free text: Bad headache with visual changes. Quite u usual qoth the visiual peoblems. Lasted about 6 hours.

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Dose 5 — Pfizer-BioNTech
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-06
Health check-in — day 7, dose 5
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-13
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-03
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-29
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-30
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-10-31	Moderna	No
4	2022-04-08	Pfizer-BioNTech	No
5	2022-09-29	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-13	priority 2/3

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Short of breath Int

2021-01-13

Systemic reaction (other): Int SOB. Started 1/8 now subsiding

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Light headed. Short of breath probably due to broncos

2021-02-06

Systemic reaction (other): SOB. SOBE

2021-02-07

Systemic reaction (other): SOB some md intermittent chest tightness probanle bronchospam

2021-02-08

Systemic reaction (other): Shakinwss. SOB. Inteemittent.

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): Hallucinated once

Release 11 — days 1–6 daily, dose 4

2022-04-12

Systemic reaction (other): Disconnected. Thinking slow. Making small errors that i would nornally not do. Brain foggy

2022-04-13

Systemic reaction (other): Fatigue difficulty concentrating

2022-04-14

Systemic reaction (other): Inability to concentrate well.

Release 11 — day 42, dose 4

2022-05-20

Symptoms: Bad headache with visual changes. Quite u usual qoth the visiual peoblems. Lasted about 6 hours.

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	Headache	·	·	✓
SD	Visual impairment	·	·	✓
SRO	Bradyphrenia	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dissociation	·	·	✓
SRO	Disturbance in attention	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Hallucination	·	·	✓
SRO	Tremor	✓	✓	✓

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