YHT-12559-96695

5 vaccinations 13 coded responses 21 check-ins 13 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 902 / CA
Registered: 2021-03-13

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-06
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Survey response — day 7, dose 1
MedDRA: Pruritus, Skin burning sensation — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Itchy, burning skin, mostly on my back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 14, dose 1
MedDRA: Fatigue, Malaise, Scratch, Skin burning sensation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, extra tired. Also have had some strange scratches on my back, skin feels like its burning. Burning feeling was since yesterday. Not prevalent now. Definitely dont feel like myself but dont know if it is related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 21, dose 1
MedDRA: Back pain, Eye pruritus, Headache, Pruritus, Skin burning sensation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Lower back pain; burning itchy skin; a little bit of headache; feminine issues; itchy eyes - allergies?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-04
Dose 2 — Moderna
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pruritus, Oral herpes — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Itchy eyes (allergies?), feel like could get cold sores

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pruritus, Pruritus — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Itchy skin and eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — day 14, dose 2
MedDRA: Back pain, Dry eye, Eye pruritus, Pain in extremity, Skin irritation — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Might be allergy related - itchy, dry eyes, flaky skin around eyes. Very irritating. Back is also itchy, scratches/scabs. More related to shot: intermittent right arm soreness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 21, dose 2
MedDRA: Back pain, Ocular hyperaemia, Pruritus — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Red, itchy eyes. Eczema-type patches on hands. Same itchy back as in the past. Lower back pain. Eyes have been very irritated. Maybe this isnt related to the vaccine; if so, maybe the question should be clarified?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headache. I rarely ever get headaches. I dont know if there is a connection to the vaccine but it is new for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 35, dose 2
MedDRA: Back pain, Pain, Rash — Feeling: Fair

Free text: Mild/moderate rash on hands, palm, face (around mouth) - but dont know that this is linked to vaccine. Lower back pain, occasional achy body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — day 42, dose 2
MedDRA: Dry mouth, Fatigue — Feeling: Fair

Free text: Dry mouth?! And still tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-04
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-03
Survey response — 6 months, dose 2
MedDRA: Anxiety, Depression, Eye disorder, Headache, Mental disorder, Pre-existing disease — Feeling: Poor · 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: I dont know if this is new, I am having bad allergies and eye issues. Its been really bad since the summer. Dealing with mental health issues too (depression?). Dont know if any of this is related to vaxx; depression is partly Covid anxiety.

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Report sent to call center — 6 months, dose 2
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 · 1 call case(s)
2021-10-05
Call 1 — Left Voicemail
2021-11-04
Dose 3 — Moderna
2022-04-06
Survey response — 12 months, dose 2
MedDRA: Anxiety, Nail infection, Nausea, Oropharyngeal pain, Serratia infection — Feeling: Good · 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: 1. Nausea & anxiety teaching masked on campus 2. Had a fingernail infection (Serratia marcescens)

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-12
Call 1 — Left Voicemail
2022-04-14
Dose 4 — Moderna
2022-07-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-14
Survey response — 6 months, dose 4
MedDRA: Gastrointestinal disorder — 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 · Outpatient clinic or urgent care clinic visit

Free text: Gastrointestinal and possible neurological issues

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-17
Call 1 — Left Voicemail
2022-12-05
Dose 5 — Moderna
2023-06-05
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-04	Moderna
3	2021-11-04	Moderna	No
4	2022-04-14	Moderna	No
5	2022-12-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-27	Unsuccessful
2021-10-03	Unsuccessful
2022-04-06	Unsuccessful
2022-10-14	Unsuccessful

Free text

Release 5 — day 7, dose 1

2021-03-13

Systemic reaction (other): Itchy, burning skin, mostly on my back

Release 6 — day 14, dose 1

2021-03-20

Symptoms: Fatigue, extra tired. Also have had some strange scratches on my back, skin feels like its burning. Burning feeling was since yesterday. Not prevalent now. Definitely dont feel like myself but dont know if it is related to the vaccine.

Release 6 — day 21, dose 1

2021-03-27

Symptoms: Lower back pain; burning itchy skin; a little bit of headache; feminine issues; itchy eyes - allergies?

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): Itchy eyes (allergies?), feel like could get cold sores

2021-04-10

Systemic reaction (other): Itchy skin and eyes

Release 7 — day 14, dose 2

2021-04-19

Symptoms: Might be allergy related - itchy, dry eyes, flaky skin around eyes. Very irritating. Back is also itchy, scratches/scabs. More related to shot: intermittent right arm soreness

Release 8 — day 21, dose 2

2021-04-26

Symptoms: Red, itchy eyes. Eczema-type patches on hands. Same itchy back as in the past. Lower back pain. Eyes have been very irritated. Maybe this isnt related to the vaccine; if so, maybe the question should be clarified?

Release 8 — day 28, dose 2

2021-05-02

Symptoms: Headache. I rarely ever get headaches. I dont know if there is a connection to the vaccine but it is new for me.

Release 8 — day 35, dose 2

2021-05-09

Symptoms: Mild/moderate rash on hands, palm, face (around mouth) - but dont know that this is linked to vaccine. Lower back pain, occasional achy body

Release 8 — day 42, dose 2

2021-05-16

Symptoms: Dry mouth?! And still tired.

Release 9 — 6 months, dose 2

2021-10-03

Symptoms: I dont know if this is new, I am having bad allergies and eye issues. Its been really bad since the summer. Dealing with mental health issues too (depression?). Dont know if any of this is related to vaxx; depression is partly Covid anxiety.

Release 11 — 12 months, dose 2

2022-04-06

Symptoms: 1. Nausea & anxiety teaching masked on campus 2. Had a fingernail infection (Serratia marcescens)

Release 12 — 6 months, dose 4

2022-10-14

Symptoms: Gastrointestinal and possible neurological issues

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	Anxiety	·	·	✓
SD	Back pain	✓	✓	✓
SD	Depression	·	·	✓
SD	Dry eye	✓	✓	✓
SD	Dry mouth	✓	✓	✓
SD	Eye disorder	·	·	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Mental disorder	·	·	✓
SD	Nail infection	·	·	✓
SD	Nausea	·	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Scratch	✓	✓	✓
SD	Serratia infection	·	·	✓
SD	Skin burning sensation	✓	✓	✓
SD	Skin irritation	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓

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