52C-10295-93867

4 vaccinations 7 coded responses 33 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 402 / KY
Registered: 2021-01-17

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Dose 2 — Moderna
2021-02-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-16
Survey response — 3 months, dose 2
MedDRA: Blindness — Feeling: Good · Be unable to do your normal daily activities

Free text: I have had TWO YAG capsulotomies since my 2nd vaccine. One was a repeat which is highly unusual, esp for an old person. I filled out a VAERS report last week. Procedures were successful but I lost vision significantly for a short time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-15
Survey response — 6 months, dose 2
MedDRA: Anaesthesia, Biopsy eyelid abnormal, Blepharoplasty, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosis of extranodal marginal zone lymphoma from biopsy taken during lower lid blepharoplasty surgery. Almost certainly present pre-vaccine. Lungs still edgy from 2 hours under anesthesia. · Healthcare visit (other): Visit with hematologist/oncologist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-15
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-22
Call 1 — Left Voicemail
2021-09-29
Dose 3 — Moderna
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-01
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good · Site: Pain

Free text: None

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-10-03
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema, Pain in extremity, Peripheral swelling, Pruritus — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: The redness, swelling, itching, and mild pain all are in skin across my upper triceps, not at the deltoid injection site. On the same arm but not at the injection site. And it got worse after my report yesterday.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: About same as yesterday re redness swelling etc.

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema, Pruritus — Feeling: Good · Site: Itching

Free text: Itchiness, redness, etc. much reduced or gone since yesterday - today is 6 days post 3rd shot.

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-10
Survey response — day 42, dose 3
MedDRA: Atrial fibrillation, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with afibrillation. Seeing cardiologist today. · Healthcare visit (other): Visit at practice

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-17
Call 1 — Left Voicemail
2021-11-22
Call successful
Does not wish to fill out VAERS report
2021-12-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-22
Dose 4 — Moderna
2022-04-01
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-05-24
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-08-23
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-02-22
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-14	Moderna
3	2021-09-29	Moderna	No
4	2022-02-22	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 8 — 3 months, dose 2

2021-05-16

Symptoms: I have had TWO YAG capsulotomies since my 2nd vaccine. One was a repeat which is highly unusual, esp for an old person. I filled out a VAERS report last week. Procedures were successful but I lost vision significantly for a short time.

Release 9 — 6 months, dose 2

2021-08-15

Symptoms: Diagnosis of extranodal marginal zone lymphoma from biopsy taken during lower lid blepharoplasty surgery. Almost certainly present pre-vaccine. Lungs still edgy from 2 hours under anesthesia.

Healthcare visit (other): Visit with hematologist/oncologist

Release 9 — days 1–6 daily, dose 3

2021-10-01

Systemic reaction (other): None

2021-10-03

Systemic reaction (other): The redness, swelling, itching, and mild pain all are in skin across my upper triceps, not at the deltoid injection site. On the same arm but not at the injection site. And it got worse after my report yesterday.

Release 10 — days 1–6 daily, dose 3

2021-10-04

Systemic reaction (other): About same as yesterday re redness swelling etc.

2021-10-05

Systemic reaction (other): Itchiness, redness, etc. much reduced or gone since yesterday - today is 6 days post 3rd shot.

Release 10 — day 42, dose 3

2021-11-10

Symptoms: Diagnosed with afibrillation. Seeing cardiologist today.

Healthcare visit (other): Visit at practice

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	Anaesthesia	✓	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Biopsy eyelid abnormal	✓	·	✓
SD	Blepharoplasty	✓	·	✓
SD	Blindness	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SRO	Erythema	·	·	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Swelling	·	·	✓

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