YDR-25102-66931

2 vaccinations 9 coded responses 24 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 540 / WI
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Moderna
2021-03-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-20
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Fair

Free text: Last few days Ive felt light headed. Dont know if that is from the vaccine or not.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Survey response — day 21, dose 1
MedDRA: Dizziness, Immune system disorder, Irritable bowel syndrome, Nasal congestion, Sinus congestion — Feeling: Fair

Free text: Light headed ness and nasal and sinus congestion that comes and goes. Also more irritable bowel systems. I feel as though my immune system is more sensitive and irritated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Dose 2 — Moderna
2021-04-10
Survey response — day 0, dose 2
MedDRA: Injected limb mobility decreased — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: Its hard to move my injection arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Limb discomfort, Self-medication — Feeling: Poor · Site: Pain, Swelling, Itching · 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: Had to take a couple naps, didnt go to work, did shower and get dressed but had to take a nap first. Did not go to church. Hard to use my left arm where I received the injection. Ibuprofen helps.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising, Injection site pain, Self-medication — Feeling: Fair · Site: Pain, Itching · Muscle or body aches

Free text: My arm is bruised at the same injection site and is still hurts to raise it up but better than yesterday. It boy had Ibuprofen once today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore tonsils

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Pain, Self-medication — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Sore tonsils - not sure if this is related. I still need Ibuprofen for body aches and cant exercise as long or as intense as did prior to the second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-24
Survey response — day 14, dose 2
MedDRA: Irritable bowel syndrome, Pre-existing disease — Feeling: Fair

Free text: Flare up of irritable bowel

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Asthma, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Asthma. I seemed to have mild asthma before but it go worse this spring. · Healthcare visit (other): Seeing a doctor for another condition but was checked for asthma.

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-11
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-04-10	Successful 2022-04-11	Participant prefers to complete VAERS report online

Free text

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Last few days Ive felt light headed. Dont know if that is from the vaccine or not.

Release 6 — day 21, dose 1

2021-04-03

Symptoms: Light headed ness and nasal and sinus congestion that comes and goes. Also more irritable bowel systems. I feel as though my immune system is more sensitive and irritated.

Release 7 — day 0, dose 2

2021-04-10

Systemic reaction (other): Its hard to move my injection arm

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Had to take a couple naps, didnt go to work, did shower and get dressed but had to take a nap first. Did not go to church. Hard to use my left arm where I received the injection. Ibuprofen helps.

2021-04-12

Systemic reaction (other): My arm is bruised at the same injection site and is still hurts to raise it up but better than yesterday. It boy had Ibuprofen once today.

2021-04-13

Systemic reaction (other): Sore tonsils

2021-04-14

Systemic reaction (other): Sore tonsils - not sure if this is related. I still need Ibuprofen for body aches and cant exercise as long or as intense as did prior to the second shot.

Release 7 — day 14, dose 2

2021-04-24

Symptoms: Flare up of irritable bowel

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: Asthma. I seemed to have mild asthma before but it go worse this spring.

Healthcare visit (other): Seeing a doctor for another condition but was checked for asthma.

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	·	·	✓
HCVO	Pre-existing disease	·	·	✓
SD	Asthma	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Immune system disorder	✓	✓	✓
SD	Irritable bowel syndrome	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Sinus congestion	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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