YJ3-16026-29224

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 330 / FL
Registered: 2021-01-15

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal pain, Myalgia, Neck pain — Feeling: Fair · Site: Pain · Muscle or body aches · 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: Moderate Muscle pain that radiates from the injection left arm to the left side of the neck and to the left shoulder blade the

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
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)
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye — Feeling: Good

Free text: Dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: Dry eye — Feeling: Good

Free text: Dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Joint range of motion decreased, Muscle spasms — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Neck muscle spasm limit motion of neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle disorder, Musculoskeletal stiffness — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stiff neck and muscle doadm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-19
Survey response — day 7, dose 2
MedDRA: SARS-CoV-2 test negative — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Its been one week since my vaccine and I got today delayed symptoms. Today I was tested for the Covid 19 One hour test negative. Three day test waiting fir result

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 14, dose 2
MedDRA: Chills, Fatigue, Headache, Myalgia, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: The eight day after my second Vacinne out of nowhere early morning I started to fill shills gradually over my body and gradually within two hours I had the following symptoms lasted all day : chills, mild fever, headache muscle pain and tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 21, dose 2
Feeling: Fair

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

Adult check-in
2021-03-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-22
Call 1 — Left Voicemail
2021-03-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-11
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-11	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-18	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): Moderate Muscle pain that radiates from the injection left arm to the left side of the neck and to the left shoulder blade the

2021-01-21

Systemic reaction (other): Dry eyes

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Dry eyes

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Neck muscle spasm limit motion of neck

2021-02-13

Systemic reaction (other): Stiff neck and muscle doadm

Release 4 — day 7, dose 2

2021-02-19

Systemic reaction (other): Its been one week since my vaccine and I got today delayed symptoms. Today I was tested for the Covid 19 One hour test negative. Three day test waiting fir result

Release 4 — day 14, dose 2

2021-02-25

Symptoms: The eight day after my second Vacinne out of nowhere early morning I started to fill shills gradually over my body and gradually within two hours I had the following symptoms lasted all day : chills, mild fever, headache muscle pain and tired.

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	Chills	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Joint range of motion decreased	✓	✓	✓
SRO	Muscle disorder	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Musculoskeletal pain	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓

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