YMT-19403-89302

4 vaccinations 10 coded responses 21 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 606 / IL
Registered: 2021-01-25

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

2021-01-21
Dose 1 — Moderna
2021-01-25
Registered in v-safe
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Only side effect was extreme muscle pain at injection site for two full days. As of day 3, pain receded the normal mild pain expected from an intramuscular injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — day 7, dose 1
MedDRA: Injection site erythema, Injection site pain — Feeling: Good · Site: Pain, Redness

Free text: Strangely, after two days of pain at the injection site, the pain slacked off and gradually disappeared...but now its back. Not as painful as at first, more like moderate. And now there is a round red mark, about the size of a dime. Weird that it would go completely away and then come back a week later. But no other side effects, everything else is fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-18
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Headache, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Symptoms much better than yesterday. As of right now (3P CST), temp has dropped to 96.3F (mine normally runs low - average 95F), so feeling much better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pruritus, Rash, Rash papular, Skin tightness, Skin warm — Feeling: Fair · Site: Pain, Redness · Headache, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Rash extends from the immediate injection site to almost the entir front of the upper arm. Area is bright red, and is slightly raised as a whole. Skin is smooth, not bumpy, feels warm and slightly tight to the touch. Moderately itchy, but not painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Constipation, Discomfort, Pyrexia — Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: Dont know if its vaccine related, but I am experiencing constipation since the injection. this is not at all normal for me, And my diet hasnt changed, except that I didnt eat at all the day following the shot and have been eating lightly since the fever went away, so Im guessing it IS related. I no longer have any abdominal pain, but def have discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation — Feeling: Good · Site: Redness

Free text: Still constipated, ugh.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Survey response — day 14, dose 2
MedDRA: Constipation, Pyrexia — Feeling: Fair

Free text: Constipation that started one day post 2nd vax continues, lessening only slightly. There has been no change in diet or activity level (activity increased after fever dissipated). Constipation is VERY rare for me. No related cause other than vax.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-19
Survey response — 6 months, dose 2
MedDRA: Vertigo — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe vertigo

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-08
Dose 3 — Moderna
2022-02-18
Survey response — 12 months, dose 2
MedDRA: Pre-existing disease, Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Bad episode of vertigo. I have had one in the past (pre- Covid), so not unique.What's this

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Dose 4 — Moderna
2022-12-26
Survey response — 6 months, dose 4
MedDRA: Malaise, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Began experiencing Covid symptoms during the night of 11/25. Tested positive 11/26 and again on 11/27. Began Paxlovid 11/28. Symptoms improved. Tested positive 12/4 and again on 12/9. Tested negative on 12/14 and again on 12/17.

MedDRA releases: 2024-11 · check-in free text available
2022-12-26
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-28
Call 1 — Left Voicemail
2022-12-29
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-18	Moderna
3	2021-12-08	Moderna	No
4	2022-06-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-26	Successful 2022-12-29	Does not wish to fill out VAERS report

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-25

Systemic reaction (other): Only side effect was extreme muscle pain at injection site for two full days. As of day 3, pain receded the normal mild pain expected from an intramuscular injection.

Release 3 — day 7, dose 1

2021-01-31

Systemic reaction (other): Strangely, after two days of pain at the injection site, the pain slacked off and gradually disappeared...but now its back. Not as painful as at first, more like moderate. And now there is a round red mark, about the size of a dime. Weird that it would go completely away and then come back a week later. But no other side effects, everything else is fine.

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Symptoms much better than yesterday. As of right now (3P CST), temp has dropped to 96.3F (mine normally runs low - average 95F), so feeling much better.

2021-02-21

Systemic reaction (other): Rash extends from the immediate injection site to almost the entir front of the upper arm. Area is bright red, and is slightly raised as a whole. Skin is smooth, not bumpy, feels warm and slightly tight to the touch. Moderately itchy, but not painful.

2021-02-22

Systemic reaction (other): Dont know if its vaccine related, but I am experiencing constipation since the injection. this is not at all normal for me, And my diet hasnt changed, except that I didnt eat at all the day following the shot and have been eating lightly since the fever went away, so Im guessing it IS related. I no longer have any abdominal pain, but def have discomfort.

2021-02-24

Systemic reaction (other): Still constipated, ugh.

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Constipation that started one day post 2nd vax continues, lessening only slightly. There has been no change in diet or activity level (activity increased after fever dissipated). Constipation is VERY rare for me. No related cause other than vax.

Release 9 — 6 months, dose 2

2021-08-19

Symptoms: Severe vertigo

Release 11 — 12 months, dose 2

2022-02-18

Symptoms: Bad episode of vertigo. I have had one in the past (pre- Covid), so not unique.What's this

Release 12 — 6 months, dose 4

2022-12-26

Symptoms: Began experiencing Covid symptoms during the night of 11/25. Tested positive 11/26 and again on 11/27. Began Paxlovid 11/28. Symptoms improved. Tested positive 12/4 and again on 12/9. Tested negative on 12/14 and again on 12/17.

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	Constipation	✓	✓	✓
SD	Malaise	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Vertigo	✓	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash papular	✓	✓	✓
SRO	Skin tightness	✓	✓	✓
SRO	Skin warm	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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