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
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2021-01-31
Dose 1 — Moderna
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2021-02-04
Registered in v-safe
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2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Gait disturbance, Pre-existing disease — Feeling: Fair · ChillsFree text: More difficulty walking (I have a pre-existing. Neurological problem)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Gait disturbance, Pre-existing disease — Feeling: Fair · Muscle or body achesFree text: More difficulty walking but Ive had neurological problems since 1993.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-07
Survey response — day 7, dose 1MedDRA: Condition aggravated, Gait disturbance, Pre-existing disease — Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Difficulty walking...worse than usualMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Survey response — day 14, dose 1MedDRA: Balance disorder, Fall, Gait disturbance — Feeling: GoodFree 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
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2021-02-21
Survey response — day 21, dose 1MedDRA: Abdominal pain upper, Diarrhoea — Feeling: FairFree text: Stomachache and diarrheaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-28
Survey response — day 28, dose 1MedDRA: Cough, Gait disturbance, Oropharyngeal pain, Product dose omission issue — Feeling: FairFree 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 foMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Dose 2 — Moderna
- 2021-03-14
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2021-03-21
Survey response — day 14, dose 2MedDRA: 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 visitFree 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
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2021-03-21
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-28
Survey response — day 21, dose 2MedDRA: 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 professionalFree 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 walkingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-28
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-04
Survey response — day 28, dose 2MedDRA: Balance disorder, Dizziness, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree 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
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2021-04-04
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-12
Survey response — day 35, dose 2MedDRA: Hypersensitivity, Nasal pruritus, Pre-existing disease, Pruritus — Feeling: FairFree text: Itching of scalp and inside nose. Allergies acting upMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-18
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2021-06-06
Survey response — 3 months, dose 2MedDRA: 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 consultationFree 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 officeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-06
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-31 | Moderna | |
| 2 | 2021-03-07 | Moderna |
Call center
| Reported | Outcome | VAERS-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
Systemic reaction (other): More difficulty walking (I have a pre-existing. Neurological problem)
Systemic reaction (other): More difficulty walking but Ive had neurological problems since 1993.
Release 3 — day 7, dose 1
Systemic reaction (other): Difficulty walking...worse than usual
Release 4 — day 14, dose 1
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
Symptoms: Stomachache and diarrhea
Release 4 — day 28, dose 1
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
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
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
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
Symptoms: Itching of scalp and inside nose. Allergies acting up
Release 8 — 3 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Gait disturbance | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Balance disorder | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyskinesia | ✓ | ✓ | ✓ |
| SD | Fall | ✓ | ✓ | ✓ |
| SD | Gait disturbance | ✓ | ✓ | ✓ |
| SD | General physical health deterioration | ✓ | · | ✓ |
| SD | Glaucoma | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Muscle spasticity | ✓ | ✓ | ✓ |
| SD | Nasal pruritus | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Product dose omission issue | ○ | ✓ | ○ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Visual impairment | ✓ | ✓ | ✓ |
| SD | Walking aid user | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Gait disturbance | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release