YUJ-33312-36820

2 vaccinations 6 coded responses 21 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 286 / NC
Registered: 2021-07-10

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

2021-07-10
Registered in v-safe
2021-07-10
Dose 1 — Moderna
2021-07-10
Health check-in — day 0, dose 1
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-07-11
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Vision blurred, Visual impairment, Vitreous floaters — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Vision issues, blurry and dots of moving light around the edge of vision, feeling dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-07-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-07-17
Health check-in — day 7, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-07-26
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-07-31
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-08-07
Dose 2 — Moderna
2021-08-07
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-08-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-08-09
Survey response — days 1–6 daily, dose 2
MedDRA: Stomatitis — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Sores in mouth

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-14
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-21
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-08-28
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-09-04
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-09-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-09-18
Survey response — day 42, dose 2
MedDRA: Fatigue, Headache, Pain, Rash, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Rash across my body, headache, congestion, feel extreme fatigue and body aches

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — 3 months, dose 2
MedDRA: Cough, Headache, Paranasal sinus discomfort, Paranasal sinus hypersecretion, Secretion discharge — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Cant seem to shake the sinus drainage, cough, and mucus. Headaches and sinus oressure every day for over a month.

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-11-10
Call 1 — Left Voicemail
2022-02-05
Survey response — 6 months, dose 2
MedDRA: Cough, Heart rate increased, Seizure — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Have had a persistent cough, rapid heart beat, and had a seizure

MedDRA releases: 2024-11 · check-in free text available
2022-08-07
Survey response — 12 months, dose 2
MedDRA: Fatigue, Headache, Muscle spasms, Respiratory tract congestion, Tendonitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tendonitis, severe muscle cramps in arms and legs, headaches, congestion, exhausted

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-10	Moderna	No
2	2021-08-07	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-06	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-07-11

Systemic reaction (other): Vision issues, blurry and dots of moving light around the edge of vision, feeling dizzy

Release 9 — days 1–6 daily, dose 2

2021-08-09

Systemic reaction (other): Sores in mouth

Release 9 — day 42, dose 2

2021-09-18

Symptoms: Rash across my body, headache, congestion, feel extreme fatigue and body aches

Release 10 — 3 months, dose 2

2021-11-06

Symptoms: Cant seem to shake the sinus drainage, cough, and mucus. Headaches and sinus oressure every day for over a month.

Release 11 — 6 months, dose 2

2022-02-05

Symptoms: Have had a persistent cough, rapid heart beat, and had a seizure

Release 12 — 12 months, dose 2

2022-08-07

Symptoms: Tendonitis, severe muscle cramps in arms and legs, headaches, congestion, exhausted

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	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Seizure	·	·	✓
SD	Tendonitis	·	·	✓
SRO	Brain fog	○	○	○
SRO	Dizziness	✓	✓	✓
SRO	Eye disorder	○	○	○
SRO	Photopsia	○	○	○
SRO	Stomatitis	✓	·	✓
SRO	Vision blurred	✓	✓	✓
SRO	Visual impairment	✓	✓	✓
SRO	Vitreous floaters	✓	✓	✓

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