YXV-26566-60815

3 vaccinations 15 coded responses 28 check-ins 15 free-text entries 8 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 760 / TX
Registered: 2021-02-15

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

2021-02-15
Registered in v-safe
2021-02-15
Dose 1 — Moderna
2021-02-15
Survey response — day 0, dose 1
MedDRA: Tinnitus — Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Survey response — day 7, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Blurred Vision (less frequently though!)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 14, dose 1
MedDRA: Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Ive had continued and worsening severe headaches and continued excessive nausea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-08
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-15
Dose 2 — Moderna
2021-03-15
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-03-15
Report sent to call center — day 0, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-03-17
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Survey response — day 14, dose 2
MedDRA: Arthralgia, Myalgia, Pre-existing disease, Psoriatic arthropathy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Since the vaccine, the muscle & joint pain has been awful! I have psoriatic arthritis, and it has flared, out of control. My rheumatologist held off treating the symptoms, so as not to interfere with the vaccine. Starting on prednisone today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — day 21, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Joint & muscle pain. Ive contacted my Rhuematologist and have added prednisone to my meds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-12
Survey response — day 28, dose 2
MedDRA: Arthralgia, Gastrointestinal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Joint pain, intestinal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-26
Survey response — day 42, dose 2
MedDRA: Autoimmune disorder, Inflammation, Pain, Pre-existing disease, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: My autoimmune stuff is glaring pretty bad again. Im still on prednisone for pain and inflammation and am concerned that its flaring up anyway. · Healthcare visit (other): Due to see Gastro & Rheumatologist in person May 19, then Nuerologist in person May 20.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Survey response — 3 months, dose 2
MedDRA: Osteoarthritis, Pre-existing disease, Psoriasis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Not new, but increased activity in both psoriatic and osteoarthritis. Been on monthly courses of steroids, as well as changed to Remicade infusions.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Call 1 — Left Voicemail
2021-08-18
Dose 3 — Moderna
2021-09-13
Survey response — 6 months, dose 2
MedDRA: Feeling abnormal, Headache, Myalgia, Nausea, Pyrexia, Stomatitis, Vision blurred — Feeling: Good · Be unable to do your normal daily activities

Free text: When I had the booster shot, I was nauseated, had muscle aches, head ache, fever, sores in my mouth, blurred vision. It was awful, for two solid weeks, then I slowly started to feel better.

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-22
Health check-in — 6 months, dose 3
Feeling: Poor

Adult check-in
2022-08-19
Survey response — 12 months, dose 3
MedDRA: Acute sinusitis, Bronchitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: A Ute Bronchitis, and sinusitis

MedDRA releases: 2024-11 · check-in free text available
2022-08-19
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online
2022-08-22
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-15	Moderna
3	2021-08-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-01	Successful 2022-08-22	Participant prefers to complete VAERS report online
2021-03-15	Successful 2022-08-22	Participant prefers to complete VAERS report online
2021-03-17	Successful 2022-08-22	Participant prefers to complete VAERS report online
2021-04-05	Successful 2022-08-22	Participant prefers to complete VAERS report online
2021-04-12	Successful 2022-08-22	Participant prefers to complete VAERS report online
2021-04-26	Successful 2022-08-22	Participant prefers to complete VAERS report online
2021-06-14	Successful 2022-08-22	Participant prefers to complete VAERS report online
2022-08-19	Successful 2022-08-22	Participant prefers to complete VAERS report online

Free text

Release 4 — day 0, dose 1

2021-02-15

Systemic reaction (other): Ringing in ears

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): Blurry vision

2021-02-17

Systemic reaction (other): Blurred vision

2021-02-18

Systemic reaction (other): Blurred vision

2021-02-19

Systemic reaction (other): Blurred vision

2021-02-20

Systemic reaction (other): Blurred vision

Release 4 — day 7, dose 1

2021-02-22

Systemic reaction (other): Blurred Vision (less frequently though!)

Release 4 — day 14, dose 1

2021-03-01

Symptoms: Ive had continued and worsening severe headaches and continued excessive nausea.

Release 6 — day 14, dose 2

2021-03-29

Symptoms: Since the vaccine, the muscle & joint pain has been awful! I have psoriatic arthritis, and it has flared, out of control. My rheumatologist held off treating the symptoms, so as not to interfere with the vaccine. Starting on prednisone today.

Release 6 — day 21, dose 2

2021-04-05

Symptoms: Joint & muscle pain. Ive contacted my Rhuematologist and have added prednisone to my meds

Release 7 — day 28, dose 2

2021-04-12

Symptoms: Joint pain, intestinal pain

Release 8 — day 42, dose 2

2021-04-26

Symptoms: My autoimmune stuff is glaring pretty bad again. Im still on prednisone for pain and inflammation and am concerned that its flaring up anyway.

Healthcare visit (other): Due to see Gastro & Rheumatologist in person May 19, then Nuerologist in person May 20.

Release 9 — 3 months, dose 2

2021-06-14

Symptoms: Not new, but increased activity in both psoriatic and osteoarthritis. Been on monthly courses of steroids, as well as changed to Remicade infusions.

Release 9 — 6 months, dose 2

2021-09-13

Symptoms: When I had the booster shot, I was nauseated, had muscle aches, head ache, fever, sores in my mouth, blurred vision. It was awful, for two solid weeks, then I slowly started to feel better.

Release 12 — 12 months, dose 3

2022-08-19

Symptoms: A Ute Bronchitis, and sinusitis

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	Unevaluable event	✓	✓	✓
SD	Acute sinusitis	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Autoimmune disorder	✓	✓	✓
SD	Bronchitis	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrointestinal pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Osteoarthritis	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Psoriasis	✓	✓	✓
SD	Psoriatic arthropathy	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Stomatitis	·	·	✓
SD	Vision blurred	·	·	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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