YLH-96555-00915

5 vaccinations 19 coded responses 57 check-ins 19 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 078 / NJ
Registered: 2021-02-04

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

Timeline

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Lacrimation increased — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Free text: Left eye teary ,as I try to do some shoveling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-11
Survey response — day 7, dose 1
MedDRA: Dysphonia, Fatigue — Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Free text: Less fatigued and tired ; but woke with A deep raspy voice : that gets Less rapsy Throughout the day: YESTERDAY had similar symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Survey response — day 0, dose 2
MedDRA: Somnolence — Feeling: Fair · Site: Redness, Swelling

Free text: Sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Eye irritation — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Diarrhea

Free text: Burning eyes (MILD)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Muscle or body aches

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Free text: Woke up with a rapsy voice : Overall wears off .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-18
Survey response — day 14, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Spasm like fleeting pain in my left knee (lasted LESS than A minute.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — 3 months, dose 2
MedDRA: Muscle spasms — Feeling: Good

Free text: Muscle cramps When I do a lot of twisting and stooping / bending : while doing gardening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Pain in my left thumb ,the finger beside : and Biting pain in my Right wrist.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling · Muscle or body aches

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Nausea

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · Site: Redness, Swelling · Joint pains

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Survey response — 3 months, dose 3
MedDRA: Diabetes mellitus, Glucose tolerance impaired, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: From pre-diabetic to Considered Diabetic( mildly) · Healthcare visit (other): Regular medical in person visit

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-01
Dose 4 — Moderna
2022-04-19
Survey response — day 14, dose 4
MedDRA: Chills, Decreased appetite, Injection site erythema, Injection site pain, Injection site swelling, Nausea, Ocular hyperaemia, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nausea , chills ,vomit Lost of appetite for Two days.April 02nd & 03rd; Pain with redness ,swelling at injection site for six days. On April 12th; I am feeling Normal! Little redness in Left eye: NO pain. Was THIS Moderna TRONGER IN ANY WAY ???

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-04-29
Survey response — day 28, dose 4
MedDRA: Ocular hyperaemia — Feeling: Good

Free text: My left eye On & Off continues to show some redness: NO pain ,just redness Compared to the Other eye.I can see fine.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Dose 5 — Moderna
Co-administered: Flu
2022-09-30
Survey response — days 1–6 daily, dose 5
MedDRA: Decreased appetite, Dry mouth — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Not hungry : dry mouth.

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-02
Survey response — days 1–6 daily, dose 5
MedDRA: Eye pruritus, Ocular hyperaemia — Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Fatigue or tiredness

Free text: Red eyes NOT RUNNY: SLIGHT ITCH IN LEFT EYE

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site discolouration — Feeling: Fair · Site: Redness, Swelling · Chills, Muscle or body aches

Free text: The area on my Right arm WHERE I got jabbed is Now black& blue.

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site discolouration — Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches

Free text: Dark blue at the area...

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site bruising — Feeling: Fair · Site: Redness, Swelling · Muscle or body aches

Free text: Bruised at injection site .

MedDRA releases: 2024-11 · check-in free text available
2022-10-06
Health check-in — day 7, dose 5
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches

Adult check-in
2022-10-13
Survey response — day 14, dose 5
MedDRA: Fatigue — Feeling: Good

Free text: Fatigued

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-11-03
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-11
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-31
Survey response — 3 months, dose 5
MedDRA: Hypertonic bladder — Feeling: Fair

Free text: OAB ,have appointment for A Cystocopy.

MedDRA releases: 2024-11 · check-in free text available
2023-03-30
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-10-28	Moderna	No
4	2022-04-01	Moderna	No
5	2022-09-29	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-01-27	Successful 2022-03-30	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — day 0, dose 1

2021-02-04

Systemic reaction (other): No

Release 3 — days 1–6 daily, dose 1

2021-02-07

Systemic reaction (other): Left eye teary ,as I try to do some shoveling.

Release 4 — day 7, dose 1

2021-02-11

Systemic reaction (other): Less fatigued and tired ; but woke with A deep raspy voice : that gets Less rapsy Throughout the day: YESTERDAY had similar symptoms.

Release 5 — day 0, dose 2

2021-03-04

Systemic reaction (other): Sleepy

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Burning eyes (MILD)

2021-03-07

Systemic reaction (other): Woke up with a rapsy voice : Overall wears off .

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Spasm like fleeting pain in my left knee (lasted LESS than A minute.

Release 8 — 3 months, dose 2

2021-06-03

Symptoms: Muscle cramps When I do a lot of twisting and stooping / bending : while doing gardening.

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Pain in my left thumb ,the finger beside : and Biting pain in my Right wrist.

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: From pre-diabetic to Considered Diabetic( mildly)

Healthcare visit (other): Regular medical in person visit

Release 11 — day 14, dose 4

2022-04-19

Symptoms: Nausea , chills ,vomit Lost of appetite for Two days.April 02nd & 03rd; Pain with redness ,swelling at injection site for six days. On April 12th; I am feeling Normal! Little redness in Left eye: NO pain. Was THIS Moderna TRONGER IN ANY WAY ???

Release 11 — day 28, dose 4

2022-04-29

Symptoms: My left eye On & Off continues to show some redness: NO pain ,just redness Compared to the Other eye.I can see fine.

Release 12 — days 1–6 daily, dose 5

2022-09-30

Systemic reaction (other): Not hungry : dry mouth.

2022-10-02

Systemic reaction (other): Red eyes NOT RUNNY: SLIGHT ITCH IN LEFT EYE

2022-10-03

Systemic reaction (other): The area on my Right arm WHERE I got jabbed is Now black& blue.

2022-10-04

Systemic reaction (other): Dark blue at the area...

2022-10-05

Systemic reaction (other): Bruised at injection site .

Release 12 — day 14, dose 5

2022-10-13

Symptoms: Fatigued

Release 12 — 3 months, dose 5

2022-12-31

Symptoms: OAB ,have appointment for A Cystocopy.

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	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Chills	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diabetes mellitus	·	·	✓
SD	Fatigue	·	·	✓
SD	Glucose tolerance impaired	·	·	✓
SD	Hypertonic bladder	·	·	✓
SD	Injection site erythema	·	·	✓
SD	Injection site pain	·	·	✓
SD	Injection site swelling	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Nausea	·	·	✓
SD	Ocular hyperaemia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Vomiting	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dry mouth	·	·	✓
SRO	Dysphonia	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Eye pruritus	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site bruising	·	·	✓
SRO	Injection site discolouration	·	·	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Ocular hyperaemia	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Somnolence	✓	✓	✓

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