YXR-21369-74129

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 891 / NV
Registered: 2021-01-07

Relationship: Self
Race: Other
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
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Joint pains, Muscle or body aches, Nausea

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Chromaturia, Nipple pain, Oedema peripheral, Swelling — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Red urine. Injection was on left shoulder. My left nipple had shooting pain. My left axillary area and left side of chest was severely swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Nausea

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Diarrhea

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Eye irritation — Feeling: Good · Fatigue or tiredness

Free text: Eyes burning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — day 7, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Headache

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 14, dose 1
MedDRA: Cough, Oropharyngeal pain, Sneezing — Feeling: Good

Free text: Sore throat, sneezing, cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — day 21, dose 1
MedDRA: Cough, Diarrhoea — Feeling: Fair

Free text: Diarrhea and a dry cough in the morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Nausea

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Survey response — day 28, dose 2
MedDRA: Diarrhoea — Feeling: Fair

Free text: Daily morning diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 35, dose 2
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Menstruation 3 times the month of February. · Healthcare visit (other): Face to face gynecologic exam

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — 3 months, dose 2
MedDRA: Abdominal pain upper, Arthralgia, Hypersensitivity, Pain — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Stomach cramps, body aches, horrible allergies, joint pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — 3 months, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Daily fluffy diarrhea.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-02
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

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

Call center

Reported	Outcome	VAERS-related outcome
2021-01-09	priority 2/3
2021-03-09	Successful 2021-06-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-04	Successful 2021-06-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 1 — day 0, dose 1

2021-01-07

Systemic reaction (other): Light headed

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Red urine. Injection was on left shoulder. My left nipple had shooting pain. My left axillary area and left side of chest was severely swollen.

2021-01-13

Systemic reaction (other): Eyes burning

Release 1 — day 7, dose 1

2021-01-14

Systemic reaction (other): Sore throat

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Sore throat, sneezing, cough.

Release 2 — day 21, dose 1

2021-01-28

Symptoms: Diarrhea and a dry cough in the morning.

Release 4 — day 28, dose 2

2021-03-02

Symptoms: Daily morning diarrhea

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Menstruation 3 times the month of February.

Healthcare visit (other): Face to face gynecologic exam

Release 8 — 3 months, dose 2

2021-05-04

Symptoms: Stomach cramps, body aches, horrible allergies, joint pain.

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: Daily fluffy diarrhea.

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	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Chromaturia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Nipple pain	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Swelling	✓	✓	✓

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