YRP-30134-48446

2 vaccinations 8 coded responses 17 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 980 / WA
Registered: 2021-03-20

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Survey response — day 0, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Site: Pain

Free text: Arm feels stiff

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Asthma, Immediate post-injection reaction, Neck pain, Oxygen saturation decreased, Paraesthesia oral, Pre-existing disease, Pyrexia — Feeling: Poor · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, 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: Yesterday after I responded I got shoulder pain that went up to my neck. My lips started tingling , Zi got feverish and broke into an asthma attack. Then my oxygen levels went down to 91 and my husband borrowed my Moms oxygenator and we got my levels up to96. I have rested most of today but still have asthma. I used my inhalers at full dose 4 times since the vaccination. These effects came on about 50 after the shot. I had already left the hospital.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Chills, Headache · Be unable to do your normal daily activities

Free text: Just still very tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Site: Itching · Headache · Be unable to do your normal daily activities

Free text: Just still tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-03
Survey response — day 14, dose 1
MedDRA: Injection site rash, Injection site swelling — Feeling: Good

Free text: Rash at vaccination site and swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Survey response — day 0, dose 2
MedDRA: Hypoaesthesia — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Free text: Neck numbness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash on hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Pain — Feeling: Fair · Site: Pain · Joint pains

Free text: General lack of breath, aching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-03
Call 1 — Left Voicemail
2022-04-20
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-21	Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-03-20

Systemic reaction (other): Arm feels stiff

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Yesterday after I responded I got shoulder pain that went up to my neck. My lips started tingling , Zi got feverish and broke into an asthma attack. Then my oxygen levels went down to 91 and my husband borrowed my Moms oxygenator and we got my levels up to96. I have rested most of today but still have asthma. I used my inhalers at full dose 4 times since the vaccination. These effects came on about 50 after the shot. I had already left the hospital.

2021-03-22

Systemic reaction (other): Just still very tired

2021-03-23

Systemic reaction (other): Just still tired

Release 6 — day 14, dose 1

2021-04-03

Symptoms: Rash at vaccination site and swelling

Release 7 — day 0, dose 2

2021-04-17

Systemic reaction (other): Neck numbness

Release 7 — days 1–6 daily, dose 2

2021-04-21

Systemic reaction (other): Rash on hands

2021-04-22

Systemic reaction (other): General lack of breath, aching

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	Injection site rash	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthma	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oxygen saturation decreased	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓

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