YUS-98739-08413

2 vaccinations 7 coded responses 26 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 014 / MA
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Survey response — day 14, dose 1
MedDRA: Injection site swelling — Feeling: Good

Free text: A bit of delayed swelling at the injection site and surrounding deltoid lasted 2 days then disappeared

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Chills — Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Late Last night I had severe chills/ shivering

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Colitis ischaemic, Hospitalisation, Unevaluable event — Feeling: Fair · Site: Redness · Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Systemic reaction (other): Diagnosed and hospitalized with ischemic colitis. · Healthcare visit (other): See previous note

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Report sent to call center — days 1–6 daily, dose 2
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)
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Ischaemic stroke — Feeling: Fair · Diarrhea · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Recovering fromIschemic colitis · Healthcare visit (other): Recovering from. Ischemic colitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Colitis ischaemic, Unevaluable event — Feeling: Good · Site: Redness, Itching · Diarrhea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Please see the last two days of reports I told you that I was diagnosed with ischemic colitis · Healthcare visit (other): I have a follow up a week from Monday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Good · Site: Itching · Diarrhea

Free text: Please see previous days reports of developing ischemic colitis the day after the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — day 7, dose 2
MedDRA: Colitis ischaemic — Feeling: Good · Site: Itching · Diarrhea

Free text: Recuperating from ischemic colitis which Ive reported multiple days in a row now after receiving the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-27
Call successful
Participant prefers to complete VAERS report online
2021-05-27
Call successful
Participant prefers to complete VAERS report online
2021-05-27
Call successful
Participant prefers to complete VAERS report online
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-08	priority 2/3
2021-02-07	Successful 2021-05-27	Participant prefers to complete VAERS report online
2021-02-08	Successful 2021-05-27	Participant prefers to complete VAERS report online
2021-02-09	Successful 2021-05-27	Participant prefers to complete VAERS report online

Free text

Release 2 — day 14, dose 1

2021-01-21

Symptoms: A bit of delayed swelling at the injection site and surrounding deltoid lasted 2 days then disappeared

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Late Last night I had severe chills/ shivering

2021-02-07

Systemic reaction (other): Diagnosed and hospitalized with ischemic colitis.

Healthcare visit (other): See previous note

2021-02-08

Systemic reaction (other): Recovering fromIschemic colitis

Healthcare visit (other): Recovering from. Ischemic colitis

2021-02-09

Systemic reaction (other): Please see the last two days of reports I told you that I was diagnosed with ischemic colitis

Healthcare visit (other): I have a follow up a week from Monday

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Please see previous days reports of developing ischemic colitis the day after the vaccine

Release 4 — day 7, dose 2

2021-02-11

Systemic reaction (other): Recuperating from ischemic colitis which Ive reported multiple days in a row now after receiving the vaccine

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	Ischaemic stroke	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Colitis ischaemic	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Ischaemic stroke	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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