YMX-79966-70259

5 vaccinations 5 coded responses 15 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 454 / OH
Registered: 2021-02-26

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

2021-01-29
Dose 1 — Moderna
2021-02-26
Registered in v-safe
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-19
Survey response — day 21, dose 2
MedDRA: Respiratory disorder — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Accidentally fell while walking my dog and broke my humerus. Hospitalized for a week also a respiratory component

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 21, 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)
2021-03-27
Survey response — day 28, dose 2
MedDRA: Fall, Gait disturbance, Hospitalisation, Humerus fracture, Medical counselling, Pain, Self-medication — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Unsteady while walking. I fell and broke left humerus in 2 places. Hospital for 9 days. Now home with rehab. Temp 99.6 today. Responded to Tylenol. Ache all over. · Healthcare visit (other): Home care with OT and PT

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Blood glucose increased, Hypoglycaemia, Unevaluable event, Urinary tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: UTI infection that caused elevated blood sugar levels followed by periods of hypoglycemia which necessitated glucagon emergency injections. Hg Dropped to 9 which then had me return for 2 IV infusions Of iron one week apart. · Healthcare visit (other): IV infusion facility

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-28
Survey response — 6 months, dose 2
MedDRA: Fatigue, Oxygen saturation decreased, Positive airway pressure therapy, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sleep apnea improving somewhat since getting Cpap machine. But episodes of a drop in o2 to 89 occurs when I feel so tired.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-08
Dose 3 — Moderna
2021-12-10
Survey response — 3 months, dose 3
MedDRA: Fall, Fatigue, Gait disturbance, Memory impairment, Vitamin B12 deficiency — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Extreme fatigue, developed Vitamin B 12 deficiency, falling and stumbling and memory problems.

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-13
Call 1 — Left Voicemail
2022-03-08
Dose 4 — Moderna
2022-11-04
Dose 5 — Pfizer-BioNTech

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-09-08	Moderna	No
4	2022-03-08	Moderna	No
5	2022-11-04	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-19	Unsuccessful
2021-03-27	Unsuccessful
2021-05-28	Unsuccessful
2021-12-10	Unsuccessful

Free text

Release 5 — day 21, dose 2

2021-03-19

Symptoms: Accidentally fell while walking my dog and broke my humerus. Hospitalized for a week also a respiratory component

Release 6 — day 28, dose 2

2021-03-27

Symptoms: Unsteady while walking. I fell and broke left humerus in 2 places. Hospital for 9 days. Now home with rehab. Temp 99.6 today. Responded to Tylenol. Ache all over.

Healthcare visit (other): Home care with OT and PT

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: UTI infection that caused elevated blood sugar levels followed by periods of hypoglycemia which necessitated glucagon emergency injections. Hg Dropped to 9 which then had me return for 2 IV infusions Of iron one week apart.

Healthcare visit (other): IV infusion facility

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: Sleep apnea improving somewhat since getting Cpap machine. But episodes of a drop in o2 to 89 occurs when I feel so tired.

Release 10 — 3 months, dose 3

2021-12-10

Symptoms: Extreme fatigue, developed Vitamin B 12 deficiency, falling and stumbling and memory problems.

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	Medical counselling	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Blood glucose increased	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Gait disturbance	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Humerus fracture	✓	✓	✓
SD	Hypoglycaemia	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Memory impairment	·	·	✓
SD	Oxygen saturation decreased	✓	·	✓
SD	Pain	✓	✓	✓
SD	Positive airway pressure therapy	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Respiratory disorder	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SD	Vitamin B12 deficiency	·	·	✓

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