YF3-20576-35616

2 vaccinations 5 coded responses 11 check-ins 5 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 137 / NY
Registered: 2021-01-07

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

2021-01-06
Dose 1 — Moderna
2021-01-07
Registered in v-safe
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Fever · Fatigue or tiredness, Nausea · 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
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-25
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-26
Call successful
Participant prefers to complete VAERS report online
2021-01-29
Survey response — day 21, dose 1
MedDRA: C-reactive protein increased, Diarrhoea, Eye swelling, Neutrophil percentage increased, Red blood cell sedimentation rate increased, White blood cell count increased — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Left eye swelling and diarrhea times three days. I have not been exposed to anyone Ive been at home.My white count is also 10.4 and I have 95% neutrophils but no evidence of any infection anywhere. I CRP at 6.78 sensitivity and my sed rate is 22

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Survey response — day 28, dose 1
MedDRA: Periorbital cellulitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I hv a periobtal cellulitis soRound I have a cellulitis around my left eye and Im on antibiotics orally and ointment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Dose 2 — Moderna
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 42, dose 2
MedDRA: Blood pressure increased, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Right arm elevated blood pressure · Healthcare visit (other): MRA and MRI of chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Dysphagia, Parotid gland enlargement, Tendon rupture — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: 2 tendon tears without trauma right foot. Large area of swelling right parotid gland. Inability to swallow food well. Fever of 99.9 F

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-19
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-08-05
Survey response — 6 months, dose 2
MedDRA: Dysphagia — Feeling: Fair · 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, Outpatient clinic or urgent care clinic visit

Free text: Lost my ability to swallow food.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 6 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

1 call case(s)
2022-02-08
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-04	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-12	Successful 2021-01-26	Participant prefers to complete VAERS report online
2021-01-29	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-02-03	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-03-18	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-05-06	Successful 2021-05-19	Reported to VAERS voluntarily prior to GDIT contact
2021-08-05	Successful	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Left eye swelling and diarrhea times three days. I have not been exposed to anyone Ive been at home.My white count is also 10.4 and I have 95% neutrophils but no evidence of any infection anywhere. I CRP at 6.78 sensitivity and my sed rate is 22

Release 3 — day 28, dose 1

2021-02-03

Symptoms: I hv a periobtal cellulitis soRound I have a cellulitis around my left eye and Im on antibiotics orally and ointment.

Release 5 — day 42, dose 2

2021-03-18

Symptoms: Right arm elevated blood pressure

Healthcare visit (other): MRA and MRI of chest

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: 2 tendon tears without trauma right foot. Large area of swelling right parotid gland. Inability to swallow food well. Fever of 99.9 F

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: Lost my ability to swallow food.

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	Unevaluable event	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	C-reactive protein increased	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dysphagia	✓	✓	✓
SD	Eye swelling	✓	✓	✓
SD	Neutrophil percentage increased	·	·	✓
SD	Parotid gland enlargement	✓	✓	✓
SD	Periorbital cellulitis	✓	✓	✓
SD	Red blood cell sedimentation rate increased	·	·	✓
SD	Tendon rupture	✓	✓	✓
SD	White blood cell count increased	·	·	✓

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