YYB-18186-09351

3 vaccinations 7 coded responses 14 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 066 / CT
Registered: 2021-05-06

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-07
Dose 1 — Moderna
2021-05-06
Registered in v-safe
2021-05-06
Dose 2 — Moderna
2021-05-06
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, 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 do your normal daily activities

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Redness, 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 do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-05-10
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: 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, Be unable to do your normal daily activities

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: 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

Adult check-in
2021-05-13
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-27
Survey response — day 21, dose 2
MedDRA: Abdominal pain, Bone pain, Diarrhoea, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Heavy abdominal cramps. Diarrhea Daily, Body and bone aches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 28, dose 2
MedDRA: Office visit, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain all over body. · Healthcare visit (other): Colorectal dr visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 28, 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)
2021-06-10
Survey response — day 35, dose 2
MedDRA: Diarrhoea, Pain, Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Diarrhea is still present.im on medications prescribed by my dr. Every night skin itching all over my body. Body aches pains still present.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Survey response — day 42, dose 2
MedDRA: Diarrhoea, Pruritus — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Major diarrhea still with medication from dr to stop it. Under the skin itching and on top of skin all over body itching thst occurs in evening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-05
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-12-29
Call 1 — Left Voicemail
2022-01-27
Dose 3 — Moderna
2022-05-03
Survey response — 3 months, dose 3
MedDRA: Breakthrough COVID-19, Skin disorder, Skin injury — 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: Caught covid-19(breakthrough) April 14th 2022. This is 2nd time I had Covid-19. The 1st Time was Nov. 2020. Getting these shots had really damaged and radhed my skin.

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
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)
2022-05-04
Call 1 — Left Voicemail
2022-07-31
Survey response — 6 months, dose 3
MedDRA: Dry throat, Epistaxis, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continual sore dry throatoy of nosebleeds.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Moderna
2	2021-05-06	Moderna
3	2022-01-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-10	Unsuccessful
2021-06-03	Unsuccessful
2022-05-03	Unsuccessful

Free text

Release 8 — day 0, dose 2

2021-05-06

Systemic reaction (other): No

Release 8 — day 21, dose 2

2021-05-27

Symptoms: Heavy abdominal cramps. Diarrhea Daily, Body and bone aches.

Release 8 — day 28, dose 2

2021-06-03

Symptoms: Pain all over body.

Healthcare visit (other): Colorectal dr visit

Release 9 — day 35, dose 2

2021-06-10

Symptoms: Diarrhea is still present.im on medications prescribed by my dr. Every night skin itching all over my body. Body aches pains still present.

Release 9 — day 42, dose 2

2021-06-17

Symptoms: Major diarrhea still with medication from dr to stop it. Under the skin itching and on top of skin all over body itching thst occurs in evening.

Release 11 — 3 months, dose 3

2022-05-03

Symptoms: Caught covid-19(breakthrough) April 14th 2022. This is 2nd time I had Covid-19. The 1st Time was Nov. 2020. Getting these shots had really damaged and radhed my skin.

Release 12 — 6 months, dose 3

2022-07-31

Symptoms: Continual sore dry throatoy of nosebleeds.

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	Office visit	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Bone pain	✓	✓	✓
SD	Breakthrough COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dry throat	·	·	✓
SD	Epistaxis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Skin disorder	·	·	✓
SD	Skin injury	·	·	✓
SRO	No adverse event	✓	✓	✓

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