YSY-25166-85927
1 vaccination
3 coded responses
15 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 874 / NM
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-01-25
Registered in v-safe
-
2021-01-25
Dose 1 — Moderna
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-01-30
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Joint pains, Fatigue or tirednessAdult check-in
- 2021-01-31
- 2021-02-01
-
2021-02-08
Survey response — day 14, dose 1MedDRA: Injection site pain, Injection site pruritus, Injection site reaction, Lymphadenopathy, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I developed a huge itchy painful whelt on my arm at the injection site. As well as swollen lymph nodes under my injection armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-15
Survey response — day 21, dose 1MedDRA: Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: My son who is 2 abs nursing had developed a whole body rash that is not explained by any other environmental factors. It has lasted 2 weeks abs began the same day as the rash I developed on my arm after my injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-15
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-04-28
-
2021-08-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-01-25
Survey response — 12 months, dose 1MedDRA: Blood cholesterol increased, Hepatic enzyme increased, Menstruation irregular — 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 visitFree text: Inconsistent periods- elevated liver levels- elevated cholesterolMedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
Report sent to call center — 12 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-15 | Successful 2021-08-01 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-01-25 | Unsuccessful |
Free text
Release 3 — day 14, dose 1
Symptoms: I developed a huge itchy painful whelt on my arm at the injection site. As well as swollen lymph nodes under my injection arm
Release 4 — day 21, dose 1
Symptoms: My son who is 2 abs nursing had developed a whole body rash that is not explained by any other environmental factors. It has lasted 2 weeks abs began the same day as the rash I developed on my arm after my injection
Release 11 — 12 months, dose 1
Symptoms: Inconsistent periods- elevated liver levels- elevated cholesterol
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 | Blood cholesterol increased | · | · | ✓ |
| SD | Hepatic enzyme increased | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Menstruation irregular | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release