YU3-32155-42035

2 vaccinations 15 coded responses 18 check-ins 15 free-text entries 9 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 431 / OH
Registered: 2021-05-27

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

2021-05-27
Registered in v-safe
2021-05-27
Dose 1 — Moderna
2021-05-27
Survey response — day 0, dose 1
MedDRA: Confusional state — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-29
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Confusion being lost

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Survey response — days 1–6 daily, dose 1
MedDRA: Bladder disorder — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Bladder issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Survey response — days 1–6 daily, dose 1
MedDRA: Bladder pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Cramps dropping me, bladder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — days 1–6 daily, dose 1
MedDRA: Aggression, Migraine, Visual impairment — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, 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: Migraine, vision changes, aggressive

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — days 1–6 daily, dose 1
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)
2021-06-03
Survey response — day 7, dose 1
MedDRA: Blood urine present, Muscle spasms — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · 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, 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: Peeing blood, constants cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 7, dose 1
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)
2021-06-10
Survey response — day 14, dose 1
MedDRA: Malaise, Migraine, Pain — Feeling: Poor · Be unable to work, 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, Emergency room or emergency department visit

Free text: Migraines, overall pain, sick feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — day 14, dose 1
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)
2021-06-17
Survey response — day 21, dose 1
MedDRA: Amnesia, Back pain, Bladder pain, Blood urine present, Bowel movement irregularity, Brain fog, Muscular weakness, Vomiting — 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: Back pain, muscle weakness, brain fog, memory loss, vomiting, urine bleeding, bladder pain. Bowel movements irregular

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 21, dose 1
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)
2021-06-17
Call 1 — Left Voicemail
2021-06-22
Dose 2 — Moderna
2021-06-23
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, 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
2021-06-24
Survey response — days 1–6 daily, dose 2
MedDRA: Amnesia, Aura, Bedridden, Blood urine, Blood urine present, Chills, Chromaturia, Confusional state, Dysarthria, Gait disturbance, Gait inability, Time perception altered, Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · 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: Peeing blood, dark dark urine, confusion, memory loss, time loss, ringing ears, color auras, bedridden, couldnt walk, slurred speech

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Call 1 — Left Voicemail
2021-06-25
Survey response — days 1–6 daily, dose 2
MedDRA: Blood urine present, Brain fog, Nipple pain, Tremor — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · 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, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Bloody urine, mood, mental fog, nipple pain, tremors

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Report sent to call center — days 1–6 daily, 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)
2021-06-26
Survey response — days 1–6 daily, dose 2
MedDRA: Blood urine present, Brain fog, Depression, Pruritus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · 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: Itching , peeing blood , mental fog , depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, 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

Adult check-in
2021-06-28
Survey response — days 1–6 daily, dose 2
MedDRA: Amnesia, Blood urine present, Brain fog, Confusional state, Dizziness, Dysuria, Feeling abnormal, Pruritus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, 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, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Trouble peeing, blood in urine, memory loss, memory fog, confusion itchy , spacey

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-28
Report sent to call center — days 1–6 daily, 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)
2021-06-29
Survey response — day 7, dose 2
MedDRA: Blood urine present, Brain fog, Syncope — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, 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, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Peeing blood, mental fog, faint,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Report sent to call center — day 7, 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)
2021-06-30
Call 1 — Left Voicemail
2021-07-08
Survey response — day 14, dose 2
MedDRA: Arthralgia, Asthenia, Bladder disorder, Myalgia, Sinus disorder — Feeling: Poor · 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: Weakness, joint/muscle pain, sinuses, bladder issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Report sent to call center — day 14, 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)
2021-07-15
Call 1 — Left Voicemail
2021-08-05
Survey response — day 42, dose 2
MedDRA: Arthralgia, Migraine, Nausea, Neuralgia, Weight increased — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Migraines, joint pain, nausea, weight gain, nerve pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — day 42, 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)
2021-10-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-27	Moderna
2	2021-06-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-02	Unsuccessful
2021-06-03	Unsuccessful
2021-06-10	Unsuccessful
2021-06-17	Unsuccessful
2021-06-25	Unsuccessful
2021-06-28	Unsuccessful
2021-06-29	Unsuccessful
2021-07-08	Unsuccessful
2021-08-05	Unsuccessful

Free text

Release 8 — day 0, dose 1

2021-05-27

Systemic reaction (other): Confusion

Release 8 — days 1–6 daily, dose 1

2021-05-29

Systemic reaction (other): Confusion being lost

2021-05-30

Systemic reaction (other): Bladder issues

2021-05-31

Systemic reaction (other): Cramps dropping me, bladder

2021-06-02

Systemic reaction (other): Migraine, vision changes, aggressive

Release 8 — day 7, dose 1

2021-06-03

Systemic reaction (other): Peeing blood, constants cramps

Release 9 — day 14, dose 1

2021-06-10

Symptoms: Migraines, overall pain, sick feeling

Release 9 — day 21, dose 1

2021-06-17

Symptoms: Back pain, muscle weakness, brain fog, memory loss, vomiting, urine bleeding, bladder pain. Bowel movements irregular

Release 9 — days 1–6 daily, dose 2

2021-06-24

Systemic reaction (other): Peeing blood, dark dark urine, confusion, memory loss, time loss, ringing ears, color auras, bedridden, couldnt walk, slurred speech

2021-06-25

Systemic reaction (other): Bloody urine, mood, mental fog, nipple pain, tremors

2021-06-26

Systemic reaction (other): Itching , peeing blood , mental fog , depression

2021-06-28

Systemic reaction (other): Trouble peeing, blood in urine, memory loss, memory fog, confusion itchy , spacey

Release 9 — day 7, dose 2

2021-06-29

Systemic reaction (other): Peeing blood, mental fog, faint,

Release 9 — day 14, dose 2

2021-07-08

Symptoms: Weakness, joint/muscle pain, sinuses, bladder issues

Release 9 — day 42, dose 2

2021-08-05

Symptoms: Migraines, joint pain, nausea, weight gain, nerve pain

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	Amnesia	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Bladder disorder	✓	✓	✓
SD	Bladder pain	✓	✓	✓
SD	Blood urine present	·	·	✓
SD	Bowel movement irregularity	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	·	✓
SD	Neuralgia	✓	·	✓
SD	Pain	✓	✓	✓
SD	Sinus disorder	✓	✓	✓
SD	Vomiting	✓	✓	✓
SD	Weight increased	✓	·	✓
SRO	Aggression	✓	✓	✓
SRO	Amnesia	✓	✓	✓
SRO	Aura	✓	✓	✓
SRO	Bedridden	✓	✓	✓
SRO	Bladder disorder	✓	✓	✓
SRO	Bladder pain	✓	✓	✓
SRO	Blood urine	✓	·	✓
SRO	Blood urine present	✓	✓	✓
SRO	Brain fog	✓	✓	✓
SRO	Chills	○	✓	○
SRO	Chromaturia	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysarthria	✓	✓	✓
SRO	Dysuria	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Gait disturbance	○	✓	○
SRO	Gait inability	✓	·	✓
SRO	Migraine	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nipple pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Syncope	✓	✓	✓
SRO	Time perception altered	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Tremor	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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