YX4-19355-95199

2 vaccinations 7 coded responses 26 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 180 / PA
Registered: 2021-04-10

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

2021-04-10
Registered in v-safe
2021-04-10
Dose 1 — Moderna
2021-04-10
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Injection site very sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Survey response — day 21, dose 1
MedDRA: Fatigue, Malaise, Pain — Feeling: Good

Free text: Last night felt achy, tired like I was getting sick. Symptoms gone today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Dose 2 — Moderna
2021-05-08
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Mobility decreased, Pain in extremity — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities

Free text: Arm was sore 5 minutes after shot. Its almost 4 hours now and I cant even lift my arm at all.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea — Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Nausea comes and goes quickly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-15
Survey response — day 7, dose 2
MedDRA: Hepatic steatosis, Tenderness — Feeling: Fair · Abdominal pain

Free text: I have a fatty liver and it has never bothered me before. Constant tenderness since last evening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-19
Survey response — day 42, dose 2
MedDRA: Fatigue, Muscle fatigue — Feeling: Fair

Free text: Very tired & fatigued muscles. Can do things but may take longer

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-08
Survey response — 12 months, dose 2
MedDRA: Dry eye, Office visit, Vision blurred — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Dry eyes constantly to the point my vision is constantly blurry unless I use drops several times daily. · Healthcare visit (other): Eye doctor visit

MedDRA releases: 2024-11 · check-in free text available
2022-05-08
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

1 call case(s)
2022-05-09
Call 1 — Left Voicemail
2022-05-13
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Moderna
2	2021-05-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-05-08	Successful 2022-05-13	Does not wish to fill out VAERS report

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-11

Systemic reaction (other): Injection site very sore

Release 8 — day 21, dose 1

2021-05-01

Symptoms: Last night felt achy, tired like I was getting sick. Symptoms gone today

Release 8 — day 0, dose 2

2021-05-08

Systemic reaction (other): Arm was sore 5 minutes after shot. Its almost 4 hours now and I cant even lift my arm at all.

Release 8 — days 1–6 daily, dose 2

2021-05-09

Systemic reaction (other): Nausea comes and goes quickly

Release 8 — day 7, dose 2

2021-05-15

Systemic reaction (other): I have a fatty liver and it has never bothered me before. Constant tenderness since last evening.

Release 9 — day 42, dose 2

2021-06-19

Symptoms: Very tired & fatigued muscles. Can do things but may take longer

Release 11 — 12 months, dose 2

2022-05-08

Symptoms: Dry eyes constantly to the point my vision is constantly blurry unless I use drops several times daily.

Healthcare visit (other): Eye doctor visit

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	Office visit	·	·	✓
SD	Dry eye	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Muscle fatigue	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Vision blurred	·	·	✓
SRO	Hepatic steatosis	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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