YMX-28293-52714

2 vaccinations 14 coded responses 17 check-ins 14 free-text entries 7 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 551 / MN
Registered: 2021-03-20

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

Registered dependents

656-13990-97638 Child or adolescent in my care · Female · 2021-07-19

J26-21977-14778 Child or adolescent in my care · Female · 2021-07-19

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-04-10
Survey response — day 21, dose 1
MedDRA: Cough, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increase in wheezing and coughing. Feels like I have stuff in my chest. More run down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Dose 2 — Moderna
2021-04-17
Survey response — day 0, dose 2
MedDRA: Balance disorder — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Feel Off balance like waves against legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme pain to the touch. Can't walk without pain. Worse than when I was sick with covid last year.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Poor · Site: Redness, Itching · Chills, Headache, Joint pains, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Numbness in foot and hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Hospitalisation — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Released from inpatient hospital today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Discharged 4/22

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-24
Survey response — day 7, dose 2
MedDRA: Hospitalisation, Hypoaesthesia — Feeling: Fair · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Numbness right hand, right leg, and right foot · Healthcare visit (other): Discharge from hospital 4/22 Dr appt 4/25

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Survey response — day 21, dose 2
MedDRA: Dysgeusia, Dyspepsia, Ear pain, Headache, Nausea, Pain, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe headache mostly right side behind right eye and ear ache. Severe Body aches today. Had some mild heartburn feeling followed by some bright yellow vomit 3 days ago and very bad sour like taste in nose and mouth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 28, dose 2
MedDRA: Balance disorder, Dizziness postural, Fatigue, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme fatigue again , soreness in legs Wgen Ealing or standing. Not steady, dizzy when standing. Better than yesterday though

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Has a day of extreme stomach ache. Better now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — day 42, dose 2
MedDRA: Balance disorder, Brain fog, Chest pain, Condition aggravated, Headache, Heart rate increased, Hospitalisation, Insomnia, Memory impairment, Postural orthostatic tachycardia syndrome, Pre-existing disease, Troponin increased — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Headaches have worsened on right side. Trouble sleeping worse. Unsteady amd have worsened brain fog and memory seem worse. Hard to control my POTS and heart rate while sitting is around 145 and up often. · Healthcare visit (other): I am unsure of I reported previously but 3 days after 2nd Dose of Moderna had sever chest pain and aitted to hospital 4/20/21 with Elevated triponin and hr 178

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-19
Survey response — 3 months, dose 2
MedDRA: Eye pain, Facial pain, Glossodynia, Headache, Office visit, Trigeminal neuralgia — 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 · Emergency room or emergency department visit

Free text: Severe pain in right side 9f face, tongue,, cheek, head, eye. Dr treating me for trigeminal neuralgia.

MedDRA releases: 2024-11 · check-in free text available
2021-07-19
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)
2021-07-23
Call 1 — Left Voicemail
2021-10-17
Survey response — 6 months, dose 2
MedDRA: Ageusia, Anosmia, Headache, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever,body aches, head aches worsened behind right eye. Had moments i could start to slightly taste and smell. I had lost taste and smell last march .as of two days ago completely not able to taste or smell anything.

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Survey response — 12 months, dose 2
MedDRA: Amnesia, Anger, Brain fog, Confusional state, Irritability, Migraine — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Worsening short term memory loss, worse brain fog,confusion, horrible migraines, more irritable and easily confused 0r angry.

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-04-20
Call 1 — Could Not Reach Participant
2022-04-25
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-21	Successful	Participant prefers to complete VAERS report online
2021-04-22	Successful	Participant prefers to complete VAERS report online
2021-04-23	Successful	Participant prefers to complete VAERS report online
2021-04-24	Successful	Participant prefers to complete VAERS report online
2021-05-29	Successful	Participant prefers to complete VAERS report online
2021-07-19	Successful	Participant prefers to complete VAERS report online
2022-04-19	Successful 2022-04-25	Participant prefers to complete VAERS report online

Free text

Release 7 — day 21, dose 1

2021-04-10

Symptoms: Increase in wheezing and coughing. Feels like I have stuff in my chest. More run down

Release 7 — day 0, dose 2

2021-04-17

Systemic reaction (other): Feel Off balance like waves against legs

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Extreme pain to the touch. Can't walk without pain. Worse than when I was sick with covid last year.

2021-04-21

Systemic reaction (other): Numbness in foot and hand

2021-04-22

Healthcare visit (other): Released from inpatient hospital today

2021-04-23

Healthcare visit (other): Discharged 4/22

Release 7 — day 7, dose 2

2021-04-24

Systemic reaction (other): Numbness right hand, right leg, and right foot

Healthcare visit (other): Discharge from hospital 4/22 Dr appt 4/25

Release 8 — day 21, dose 2

2021-05-14

Symptoms: Severe headache mostly right side behind right eye and ear ache. Severe Body aches today. Had some mild heartburn feeling followed by some bright yellow vomit 3 days ago and very bad sour like taste in nose and mouth.

Release 8 — day 28, dose 2

2021-05-15

Symptoms: Extreme fatigue again , soreness in legs Wgen Ealing or standing. Not steady, dizzy when standing. Better than yesterday though

Release 8 — day 35, dose 2

2021-05-22

Symptoms: Has a day of extreme stomach ache. Better now.

Release 8 — day 42, dose 2

2021-05-29

Symptoms: Headaches have worsened on right side. Trouble sleeping worse. Unsteady amd have worsened brain fog and memory seem worse. Hard to control my POTS and heart rate while sitting is around 145 and up often.

Healthcare visit (other): I am unsure of I reported previously but 3 days after 2nd Dose of Moderna had sever chest pain and aitted to hospital 4/20/21 with Elevated triponin and hr 178

Release 9 — 3 months, dose 2

2021-07-19

Symptoms: Severe pain in right side 9f face, tongue,, cheek, head, eye. Dr treating me for trigeminal neuralgia.

Release 10 — 6 months, dose 2

2021-10-17

Symptoms: Fever,body aches, head aches worsened behind right eye. Had moments i could start to slightly taste and smell. I had lost taste and smell last march .as of two days ago completely not able to taste or smell anything.

Release 11 — 12 months, dose 2

2022-04-19

Symptoms: Worsening short term memory loss, worse brain fog,confusion, horrible migraines, more irritable and easily confused 0r angry.

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	Chest pain	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Troponin increased	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Ageusia	·	·	✓
SD	Amnesia	·	·	✓
SD	Anger	·	·	✓
SD	Anosmia	·	·	✓
SD	Balance disorder	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Confusional state	·	·	✓
SD	Cough	✓	✓	✓
SD	Dizziness postural	✓	✓	✓
SD	Dysgeusia	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Eye pain	·	·	✓
SD	Facial pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Glossodynia	·	·	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Irritability	·	·	✓
SD	Memory impairment	✓	✓	✓
SD	Migraine	·	·	✓
SD	Nausea	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Postural orthostatic tachycardia syndrome	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Trigeminal neuralgia	·	·	✓
SD	Vomiting	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Pain	✓	✓	✓

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