YGS-80509-42336

4 vaccinations 10 coded responses 28 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 371 / TN
Registered: 2021-03-12

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-03
Dose 1 — Moderna
2021-03-12
Registered in v-safe
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Survey response — day 0, dose 2
MedDRA: Rhinorrhoea — Feeling: Good · Chills

Free text: Nose running.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Pollakiuria, Rhinorrhoea, Somnolence — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache

Free text: Had moderate chills after answering questionnaire yesterday, runny nose-mild, tired and sleepy and frequent urination. Feel much better today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased, Blood pressure increased — Feeling: Good · Site: Swelling, Itching

Free text: Blood pressure and blood sugar has been slightly elevated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea, Faeces soft — Feeling: Good · Site: Itching · Diarrhea · Be unable to do your normal daily activities

Free text: Been dealing with diarrhea for past two and a half days. Not long after food hits my stomach, I have to go empty bowels. Soft stool.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased, Blood pressure increased — Feeling: Good

Free text: Everything listed before seems to have stopped. Im still noticing a slight elevation of blood pressure and blood sugar readings.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Still dealing with some diarrhea after I eat a meal. Not sure if its coming from the vaccine or the metformin I started taking on Friday, April 16,2021. I was dealing with some diarrhea prior to the metformin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 28, dose 2
MedDRA: Asthenia, Gastric disorder — Feeling: Good

Free text: Cant seem to get my energy back. The issue with my stomach I believe is do to some new medicine my doctor has me on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Computerised tomogram heart abnormal, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Had cardiac calcium scoring CT done 6/28/21. Results show high risk. PCP changed cholesterol meds, referring me to a cardiologist. Im scheduled for eye surgery 7/28/21. · Healthcare visit (other): Waiting to be referred to cardiologist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-06
Call 1 — Left Voicemail
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-19
Dose 3 — Moderna
2022-01-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-01-28
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-02-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-02
Survey response — day 42, dose 3
MedDRA: Anaemia, Glaucoma, Office visit, Pre-existing disease, Unevaluable event — Feeling: Good

Free text: Issues with my glaucoma, left eye. Scar tissue to remove and insert a tube. Seeing a doctor about anemia and having an echocardiogram done.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-09
Dose 4 — Moderna
Co-administered: Flu
2023-02-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-13
Survey response — 6 months, dose 4
MedDRA: Breast cancer, Cancer surgery — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2022-01-19	Moderna	No
4	2022-11-09	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-07-01	Unsuccessful

Free text

Release 6 — day 0, dose 2

2021-03-31

Systemic reaction (other): Nose running.

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Had moderate chills after answering questionnaire yesterday, runny nose-mild, tired and sleepy and frequent urination. Feel much better today.

2021-04-03

Systemic reaction (other): Blood pressure and blood sugar has been slightly elevated.

2021-04-04

Systemic reaction (other): Been dealing with diarrhea for past two and a half days. Not long after food hits my stomach, I have to go empty bowels. Soft stool.

2021-04-05

Systemic reaction (other): Everything listed before seems to have stopped. Im still noticing a slight elevation of blood pressure and blood sugar readings.

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Still dealing with some diarrhea after I eat a meal. Not sure if its coming from the vaccine or the metformin I started taking on Friday, April 16,2021. I was dealing with some diarrhea prior to the metformin.

Release 8 — day 28, dose 2

2021-04-28

Symptoms: Cant seem to get my energy back. The issue with my stomach I believe is do to some new medicine my doctor has me on.

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Had cardiac calcium scoring CT done 6/28/21. Results show high risk. PCP changed cholesterol meds, referring me to a cardiologist. Im scheduled for eye surgery 7/28/21.

Healthcare visit (other): Waiting to be referred to cardiologist.

Release 11 — day 42, dose 3

2022-03-02

Symptoms: Issues with my glaucoma, left eye. Scar tissue to remove and insert a tube. Seeing a doctor about anemia and having an echocardiogram done.

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	Unevaluable event	✓	✓	✓
SD	Anaemia	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Breast cancer	·	·	✓
SD	Cancer surgery	·	·	✓
SD	Computerised tomogram abnormal	○	○	○
SD	Computerised tomogram heart abnormal	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Gastric disorder	✓	✓	✓
SD	Glaucoma	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Faeces soft	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Pollakiuria	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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