YC5-15098-54254

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 967 / HI
Registered: 2021-02-16

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

2021-02-16
Registered in v-safe
2021-02-16
Dose 1 — Moderna
2021-02-16
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-16
Dose 2 — Moderna
2021-03-16
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Renal pain — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Lower back pain. ( not new: developed yesterday. Started with kidney pain in morning. Then became broader, lower, and less intense. Almost gone , now, actually. Sorry I forgot to mention it yesterday; it was among the first things Id noticed when I got out of bed yesterday morning early. Spent most of yesterday in bed. Stayed home today, just in case, but really: much better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Ophthalmic migraine, Sleep deficit — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea

Free text: The above symptoms are probably unrelated to the vaccine. They are consistent with an ocular migraine, triggered by inadequate sleep and/or hydration, being out in the sun without proper eye protection, and suddenly dropping my head below my waist (tying my shoes).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: Nope; all good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — day 7, dose 2
MedDRA: Choking, Retching — Feeling: Good

Free text: Gagging/choking on normal size bites at lunch today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-14
Survey response — 6 months, dose 2
MedDRA: Cough, Upper-airway cough syndrome — Feeling: Good

Free text: Had a light cough this morning (possible mask fiber irritation), and some post nasal gunk in the last 2-3 weeks when I lie down to sleep.

MedDRA releases: 2024-11 · check-in free text available
2022-03-18
Survey response — 12 months, dose 2
MedDRA: Ear discomfort, Fall, Ligament sprain, Vertigo — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Stuffy ears and mild vertigo. Probably unrelated: jammed ring finger and pinky on right hand in a slip and fall around the same time, last month. It was rainy and the tread on my flip flops was worn.

MedDRA releases: 2024-11 · check-in free text available
2022-03-18
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Moderna
2	2021-03-16	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-03-18	Successful 2022-03-22	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-17

Systemic reaction (other): Brain fog

2021-03-18

Systemic reaction (other): Lower back pain. ( not new: developed yesterday. Started with kidney pain in morning. Then became broader, lower, and less intense. Almost gone , now, actually. Sorry I forgot to mention it yesterday; it was among the first things Id noticed when I got out of bed yesterday morning early. Spent most of yesterday in bed. Stayed home today, just in case, but really: much better.

2021-03-19

Systemic reaction (other): The above symptoms are probably unrelated to the vaccine. They are consistent with an ocular migraine, triggered by inadequate sleep and/or hydration, being out in the sun without proper eye protection, and suddenly dropping my head below my waist (tying my shoes).

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Nope; all good

Release 6 — day 7, dose 2

2021-03-23

Systemic reaction (other): Gagging/choking on normal size bites at lunch today.

Release 9 — 6 months, dose 2

2021-09-14

Symptoms: Had a light cough this morning (possible mask fiber irritation), and some post nasal gunk in the last 2-3 weeks when I lie down to sleep.

Release 11 — 12 months, dose 2

2022-03-18

Symptoms: Stuffy ears and mild vertigo. Probably unrelated: jammed ring finger and pinky on right hand in a slip and fall around the same time, last month. It was rainy and the tread on my flip flops was worn.

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
SD	Cough	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Fall	·	·	✓
SD	Ligament sprain	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SD	Vertigo	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Choking	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Ophthalmic migraine	✓	✓	✓
SRO	Renal pain	✓	✓	✓
SRO	Retching	✓	✓	✓
SRO	Sleep deficit	✓	✓	✓

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