YXV-20206-95818

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

Sex: Female
Age at first dose: 51-55
ZIP prefix: 100 / NY
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Nausea, Diarrhea

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Self-medication — Feeling: Good

Free text: Late yesterday after check in I had a low grade fever (99.3) Took 2 advil which took care of it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-28
Survey response — day 14, dose 1
MedDRA: Abdominal discomfort, Asthenia, Faeces hard, Frequent bowel movements, Gastrointestinal pain, Pyrexia, Tremor — Feeling: Fair · Be unable to do your normal daily activities

Free text: Low grade fever, a bit weak and shaky, GI issues - hard stool, painful & frequent bowel movements

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea, Vertigo — Feeling: Fair · Nausea · Be unable to do your normal daily activities

Free text: Vertigo is moderate, nausea is mild - maybe not from vaccine-?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 35, dose 2
MedDRA: Asthenia, COVID-19, Condition aggravated, Epstein-Barr virus infection, Epstein-Barr virus infection reactivation, Hepatic enzyme increased, Liver function test abnormal, Medical observation, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Reactivation of the Epstein Barr virus which I think happened as a result of my immune system being occupied with creating antibodies for COVID-19. My energy levels never returned to what they were prior to my 2nd vaccination. · Healthcare visit (other): Saw my PCP who did a full physical and bloodwork. Elevated liver enzymes led him to check for the Epstein Barr virus.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-12-22
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-18	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Late yesterday after check in I had a low grade fever (99.3) Took 2 advil which took care of it.

Release 3 — day 14, dose 1

2021-01-28

Symptoms: Low grade fever, a bit weak and shaky, GI issues - hard stool, painful & frequent bowel movements

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): Vertigo is moderate, nausea is mild - maybe not from vaccine-?

2021-02-17

Systemic reaction (other): Vertigo

Release 4 — day 7, dose 2

2021-02-18

Systemic reaction (other): Dizziness

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Reactivation of the Epstein Barr virus which I think happened as a result of my immune system being occupied with creating antibodies for COVID-19. My energy levels never returned to what they were prior to my 2nd vaccination.

Healthcare visit (other): Saw my PCP who did a full physical and bloodwork. Elevated liver enzymes led him to check for the Epstein Barr virus.

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	Epstein-Barr virus infection	○	✓	○
HCVO	Hepatic enzyme increased	✓	·	✓
HCVO	Liver function test abnormal	○	✓	○
HCVO	Medical observation	○	✓	○
HCVO	Office visit	✓	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	○	✓	○
SD	Epstein-Barr virus infection reactivation	○	✓	○
SD	Faeces hard	✓	✓	✓
SD	Frequent bowel movements	✓	✓	✓
SD	Gastrointestinal pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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