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YWV-43499-72522

2 vaccinations 11 coded responses 13 check-ins 11 free-text entries 4 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
968 / HI
Registered
2021-02-04
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-31
    Dose 1 — Moderna
  2. 2021-02-04
    Registered in v-safe
  3. 2021-02-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Gait disturbance, Pre-existing disease — Feeling: Fair · Chills
    Free text: More difficulty walking (I have a pre-existing. Neurological problem)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-06
    Survey response — days 1–6 daily, dose 1
    MedDRA: Gait disturbance, Pre-existing disease — Feeling: Fair · Muscle or body aches
    Free text: More difficulty walking but Ive had neurological problems since 1993.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-07
    Survey response — day 7, dose 1
    MedDRA: Condition aggravated, Gait disturbance, Pre-existing disease — Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities
    Free text: Difficulty walking...worse than usual
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-14
    Survey response — day 14, dose 1
    MedDRA: Balance disorder, Fall, Gait disturbance — Feeling: Good
    Free text: More difficulty walking. Dont know what it is but my balance is worse and I seem to fall about once a week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-21
    Survey response — day 21, dose 1
    MedDRA: Abdominal pain upper, Diarrhoea — Feeling: Fair
    Free text: Stomachache and diarrhea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-28
    Survey response — day 28, dose 1
    MedDRA: Cough, Gait disturbance, Oropharyngeal pain, Product dose omission issue — Feeling: Fair
    Free text: Seem to have trouble walking. My housemates. Prices that I am walking funny. I walk like a mummy. Dont know whats wrong. Didnt go for my second shot today. Got up with a sore throat and cough so didnt go. Am all right now. Will go fo
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-07
    Dose 2 — Moderna
  10. 2021-03-14
    Health check-in — day 7, dose 2
    Feeling: Fair · Headache, Abdominal pain
    Adult check-in
  11. 2021-03-21
    Survey response — day 14, dose 2
    MedDRA: Dyskinesia, Gait disturbance, Visual impairment — Feeling: Fair · 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: Im having a difficult time walking. My body is jerky or dangly. My housemate thinks Ive deteriorated and walk funny. My reading vision has deteriorated.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-21
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-03-28
    Survey response — day 21, dose 2
    MedDRA: Balance disorder, Gait disturbance, General physical health deterioration, Muscle spasticity, Unevaluable event, Walking aid user — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: My balance is worse and I can no longer walk without a cane or walker. My legsare spastic when I walk. My housemate says I deteriorated greatly the past few weeks. · Healthcare visit (other): I need to make an appointment with a physiatrist on Monday to see what is the cause of the difficulty walking
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-28
    Report sent to call center — day 21, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  15. 2021-04-04
    Survey response — day 28, dose 2
    MedDRA: Balance disorder, Dizziness, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Lost my balance and fell hiting my hip, arm and head. Got a spell of dizziness 5 minutes after. Since the vaccine my body has felt disconnected like the lungs arent connected to each other. I look spastic when I walk. · Healthcare visit (other): I am seeing a physiatrist tomorrow. My rheumatologist recommended I make an appointment.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-04
    Report sent to call center — day 28, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-04-12
    Survey response — day 35, dose 2
    MedDRA: Hypersensitivity, Nasal pruritus, Pre-existing disease, Pruritus — Feeling: Fair
    Free text: Itching of scalp and inside nose. Allergies acting up
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-18
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-06-06
    Survey response — 3 months, dose 2
    MedDRA: Glaucoma, Office visit, Pre-existing disease, Visual impairment — 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: Symptoms: My vision and hearing have deteriorated. The tv volume has to be set at 20 instead of 5. I have glaucoma. My eye pressure is fine but the physician cant figure out why my vision has deteriorated so much. There is spasticity when I walk. · Healthcare visit (other): Routine visit at physicians office
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-06-06
    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)
  21. 2021-06-16

Vaccinations

DoseDateManufacturerCo-administered
12021-01-31Moderna
22021-03-07Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-03-21 Unsuccessful
2021-03-28 Unsuccessful
2021-04-04 Unsuccessful
2021-06-06 Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): More difficulty walking (I have a pre-existing. Neurological problem)

2021-02-06

Systemic reaction (other): More difficulty walking but Ive had neurological problems since 1993.

Release 3 — day 7, dose 1

2021-02-07

Systemic reaction (other): Difficulty walking...worse than usual

Release 4 — day 14, dose 1

2021-02-14

Symptoms: More difficulty walking. Dont know what it is but my balance is worse and I seem to fall about once a week.

Release 4 — day 21, dose 1

2021-02-21

Symptoms: Stomachache and diarrhea

Release 4 — day 28, dose 1

2021-02-28

Symptoms: Seem to have trouble walking. My housemates. Prices that I am walking funny. I walk like a mummy. Dont know whats wrong. Didnt go for my second shot today. Got up with a sore throat and cough so didnt go. Am all right now. Will go fo

Release 6 — day 14, dose 2

2021-03-21

Symptoms: Im having a difficult time walking. My body is jerky or dangly. My housemate thinks Ive deteriorated and walk funny. My reading vision has deteriorated.

Release 6 — day 21, dose 2

2021-03-28

Symptoms: My balance is worse and I can no longer walk without a cane or walker. My legsare spastic when I walk. My housemate says I deteriorated greatly the past few weeks.
Healthcare visit (other): I need to make an appointment with a physiatrist on Monday to see what is the cause of the difficulty walking

Release 6 — day 28, dose 2

2021-04-04

Symptoms: Lost my balance and fell hiting my hip, arm and head. Got a spell of dizziness 5 minutes after. Since the vaccine my body has felt disconnected like the lungs arent connected to each other. I look spastic when I walk.
Healthcare visit (other): I am seeing a physiatrist tomorrow. My rheumatologist recommended I make an appointment.

Release 7 — day 35, dose 2

2021-04-12

Symptoms: Itching of scalp and inside nose. Allergies acting up

Release 8 — 3 months, dose 2

2021-06-06

Symptoms: My vision and hearing have deteriorated. The tv volume has to be set at 20 instead of 5. I have glaucoma. My eye pressure is fine but the physician cant figure out why my vision has deteriorated so much. There is spasticity when I walk.
Healthcare visit (other): Routine visit at physicians office

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

FieldPreferred term2021-092023-042024-11
HCVOGait disturbance ✓ ✓ ✓
HCVOOffice visit ✓ ✓ ✓
HCVOUnevaluable event ✓ ✓ ✓
SDAbdominal pain upper ✓ ✓ ✓
SDBalance disorder ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDDiarrhoea ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDDyskinesia ✓ ✓ ✓
SDFall ✓ ✓ ✓
SDGait disturbance ✓ ✓ ✓
SDGeneral physical health deterioration ✓ · ✓
SDGlaucoma ✓ ✓ ✓
SDHypersensitivity ✓ ✓ ✓
SDMuscle spasticity ✓ ✓ ✓
SDNasal pruritus ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDProduct dose omission issue ○ ✓ ○
SDPruritus ✓ ✓ ✓
SDVisual impairment ✓ ✓ ✓
SDWalking aid user ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROGait disturbance ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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