YSX-19294-21935

2 vaccinations 11 coded responses 24 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 836 / ID
Registered: 2021-02-14

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

2021-02-13
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Joint swelling — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: My right knee is sore anyway but is worse today and swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pre-existing disease, Unevaluable event — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I believe my pain & symptoms are related to my (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Having a hard time staying awake

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 7, dose 2
MedDRA: Hypersomnia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sleeping too much

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 28, dose 2
MedDRA: Back pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Low back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 35, dose 2
MedDRA: Back pain, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: More back pain and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-14
Survey response — 3 months, dose 2
MedDRA: Rib fracture — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Broken Rib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Cough, Fatigue, Hospitalisation, Joint swelling, Office visit, Peripheral swelling — Feeling: Poor · 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: Symptoms: I have had serious knee pain and leg swelling especially in ankles.Also coughing much more and extreme fatigue. My Pulmonologist and rheumatologist are currently running tests and working with me. They want to rule out pneumonia and blood clots. · Healthcare visit (other): X-rays & blood work at hospital. Contrast CAT scan of chest to show all blood vessels is scheduled for this coming week.

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
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)
2021-09-16
Call 1 — Left Voicemail
2022-03-13
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Back pain, Cough, Gait inability — Feeling: Poor · 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: Increased coughing, increased knee and back pain unable to walk. Using power wheelchair full time.

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-14	Successful 2021-06-23	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-11	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-13	Successful 2022-03-15	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-15

Systemic reaction (other): My right knee is sore anyway but is worse today and swollen.

2021-02-16

Systemic reaction (other): I believe my pain & symptoms are related to my (b)(6)

redacted (b)(6)

2021-02-18

Systemic reaction (other): Short of breath

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): Exhaustion

2021-03-19

Systemic reaction (other): Having a hard time staying awake

Release 6 — day 7, dose 2

2021-03-20

Systemic reaction (other): Sleeping too much

Release 7 — day 28, dose 2

2021-04-10

Symptoms: Low back pain

Release 7 — day 35, dose 2

2021-04-17

Symptoms: More back pain and fatigue.

Release 9 — 3 months, dose 2

2021-06-14

Symptoms: Broken Rib

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: I have had serious knee pain and leg swelling especially in ankles.Also coughing much more and extreme fatigue. My Pulmonologist and rheumatologist are currently running tests and working with me. They want to rule out pneumonia and blood clots.

Healthcare visit (other): X-rays & blood work at hospital. Contrast CAT scan of chest to show all blood vessels is scheduled for this coming week.

Release 11 — 12 months, dose 2

2022-03-13

Symptoms: Increased coughing, increased knee and back pain unable to walk. Using power wheelchair full time.

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	Hospitalisation	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Cough	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gait inability	·	·	✓
SD	Joint swelling	·	·	✓
SD	Office visit	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Rib fracture	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Somnolence	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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