YPH-10022-43327

3 vaccinations 7 coded responses 9 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 147 / NY
Registered: 2021-09-23

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

2021-02-17
Dose 1 — Moderna
2021-03-17
Dose 2 — Moderna
2021-09-21
Dose 3 — Moderna
2021-09-23
Registered in v-safe
2021-09-23
Survey response — days 1–6 daily, dose 3
MedDRA: Rheumatoid arthritis — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rheumatoid arthritis

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal discomfort, Rheumatoid arthritis — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rheumatoid arthritis & left abdominal discomfort

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Survey response — days 1–6 daily, dose 3
MedDRA: Diarrhoea, Faeces discoloured, Oropharyngeal discomfort, Rheumatoid arthritis — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rheumatoid arthritis, green diarrhea, left side of throat swallowing uncomfortable

MedDRA releases: 2024-11 · check-in free text available
2021-09-26
Survey response — days 1–6 daily, dose 3
MedDRA: Faeces discoloured, Oropharyngeal pain, Rheumatoid arthritis — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rheumatoid arthritis, left side of throat sore, green diarrhea

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-28
Survey response — day 7, dose 3
MedDRA: Flank pain, Painful respiration, Pre-existing disease, Rheumatoid arthritis, Sneezing — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rheumatoid arthritis flare, left side pain when sneezing or breathing deeply

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Health check-in — day 21, dose 3
Feeling: Poor

Adult check-in
2021-10-21
Survey response — day 28, dose 3
MedDRA: Pre-existing disease, Rheumatoid arthritis, Systemic lupus erythematosus — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Developed lupus-like symptoms in addition to my rheumatoid arthritis and still experiencing significant flares

MedDRA releases: 2024-11 · check-in free text available
2022-03-22
Survey response — 6 months, dose 3
MedDRA: Systemic lupus erythematosus — 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

Free text: Lupus

MedDRA releases: 2024-11 · check-in free text available
2022-03-22
Report sent to call center — 6 months, dose 3
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 · 1 call case(s)
2022-03-23
Call 1 — Could Not Reach Participant
2022-03-28
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna	No
2	2021-03-17	Moderna	No
3	2021-09-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-22	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 3

2021-09-23

Systemic reaction (other): Rheumatoid arthritis

2021-09-24

Systemic reaction (other): Rheumatoid arthritis & left abdominal discomfort

2021-09-25

Systemic reaction (other): Rheumatoid arthritis, green diarrhea, left side of throat swallowing uncomfortable

2021-09-26

Systemic reaction (other): Rheumatoid arthritis, left side of throat sore, green diarrhea

Release 9 — day 7, dose 3

2021-09-28

Systemic reaction (other): Rheumatoid arthritis flare, left side pain when sneezing or breathing deeply

Release 10 — day 28, dose 3

2021-10-21

Symptoms: Developed lupus-like symptoms in addition to my rheumatoid arthritis and still experiencing significant flares

Release 11 — 6 months, dose 3

2022-03-22

Symptoms: Lupus

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	Pre-existing disease	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SD	Systemic lupus erythematosus	·	·	✓
SRO	Abdominal discomfort	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Faeces discoloured	·	·	✓
SRO	Flank pain	·	·	✓
SRO	Oropharyngeal discomfort	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Painful respiration	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Rheumatoid arthritis	·	·	✓
SRO	Sneezing	·	·	✓

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