YYT-16946-42582

2 vaccinations 8 coded responses 14 check-ins 8 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 088 / NJ
Registered: 2021-02-06

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

2021-01-07
Dose 1 — Moderna
2021-02-04
Dose 2 — Moderna
2021-02-06
Registered in v-safe
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylactic reaction, Hospitalisation — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): had anaphylactic reaction to vaccine day 1 and still inpatient in hospital · Healthcare visit (other): hospitalized since feb 4th

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Report sent to call center — days 1–6 daily, 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)
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Chest pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: shoulder pain and chest pain but may be related to car accident day prior to vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Report sent to call center — days 1–6 daily, 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)
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Bronchospasm, Hospitalisation — Feeling: Poor · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): bronchospasms · Healthcare visit (other): discharge cancelled for today steriods increased again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — days 1–6 daily, 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)
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Hospitalisation — Feeling: Fair · Fever · Chills, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): shortness of breath · Healthcare visit (other): still in hospital for treatment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — days 1–6 daily, 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)
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Dyspnoea, Hospitalisation, Unevaluable event — Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): discharged from hispitsl today still short of breath and weak · Healthcare visit (other): discharged home today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — days 1–6 daily, 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)
2021-02-13
Survey response — day 7, dose 2
MedDRA: Hiatus hernia, Swelling face — Feeling: Poor · Joint pains, Fatigue or tiredness, 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: face swollen and hives

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Survey response — day 42, dose 2
MedDRA: Myalgia, Vertigo — Feeling: Fair · Be unable to do your normal daily activities

Free text: vertigo muscle pains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-22
Call 1 — Requested Callback
2021-07-22
Callback requested for
06:00PM ET
2021-07-22
Call successful
Participant prefers to complete VAERS report online
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-04
Survey response — 12 months, dose 2
MedDRA: COVID-19 — 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, Emergency room or emergency department visit

Free text: got covid

MedDRA releases: 2024-11 · check-in free text available
2022-02-04
Report sent to call center — 12 months, 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

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-02-07
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-06	Successful	Does not wish to fill out VAERS report
2021-02-07	Successful	Participant prefers to complete VAERS report online
2021-02-08	Successful	Participant prefers to complete VAERS report online
2021-02-09	Successful	Participant prefers to complete VAERS report online
2021-02-10	Successful 2021-07-22	Participant prefers to complete VAERS report online
2022-02-04	Successful 2022-02-07	Does not wish to fill out VAERS report

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): had anaphylactic reaction to vaccine day 1 and still inpatient in hospital

Healthcare visit (other): hospitalized since feb 4th

2021-02-07

Systemic reaction (other): shoulder pain and chest pain but may be related to car accident day prior to vaccination

2021-02-08

Systemic reaction (other): bronchospasms

Healthcare visit (other): discharge cancelled for today steriods increased again

2021-02-09

Systemic reaction (other): shortness of breath

Healthcare visit (other): still in hospital for treatment

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): discharged from hispitsl today still short of breath and weak

Healthcare visit (other): discharged home today

Release 4 — day 7, dose 2

2021-02-13

Systemic reaction (other): face swollen and hives

Release 5 — day 42, dose 2

2021-03-18

Symptoms: vertigo muscle pains

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: got covid

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	Hospitalisation	✓	✓	✓
HCVO	Unevaluable event	○	✓	○
SD	COVID-19	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Bronchospasm	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hiatus hernia	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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