YXY-25960-52715

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1399328 (opens in a new window)	high	9 / 11	2	2 of 11 VAERS symptoms	same dose (1)	KY matches	2021-01-06 / 2021-01-08 / 2021-06-15 received the same day as the last call	case 472151

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Fever · Headache

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional

Free text: Optometrist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pain — Feeling: Fair

Free text: L eye pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Survey response — day 7, dose 1
MedDRA: Eye pain — Feeling: Fair

Free text: L eye pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-27
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-03
Survey response — day 28, dose 1
MedDRA: Unevaluable event, Uveitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Have uveitis in my left eye. Been seeing retinal specialist since one week post first vaccine. Seeing uveitis specialist next week. · Healthcare visit (other): Many eye doctor appointments

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-02-17
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-02-25
Call successful
Participant prefers to complete VAERS report online
2021-04-07
Survey response — 3 months, dose 1
MedDRA: Blindness, Eye pain, Latent tuberculosis, Ocular hyperaemia, Office visit, Pre-existing disease, Uveitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Vision loss from uveitis and latent tuberculosis in my left eye. Redness and mild tenderness in left eye. I believe vaccine caused my body to attack problems that were dormant · Healthcare visit (other): Appointment with a uveitis specialist at (b)(6). Also infectious disease specialist in (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Call successful
Completed over the phone
2021-07-07
Health check-in — 6 months, dose 1
Feeling: Fair

Adult check-in
2022-01-06
Health check-in — 12 months, dose 1
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-11	Successful	Participant prefers to complete VAERS report online
2021-02-03	Successful 2021-02-25	Participant prefers to complete VAERS report online
2021-04-07	Successful 2021-06-15	Completed over the phone

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-11

Healthcare visit (other): Optometrist

2021-01-12

Systemic reaction (other): L eye pain

Release 1 — day 7, dose 1

2021-01-13

Systemic reaction (other): L eye pain

Release 3 — day 28, dose 1

2021-02-03

Symptoms: Have uveitis in my left eye. Been seeing retinal specialist since one week post first vaccine. Seeing uveitis specialist next week.

Healthcare visit (other): Many eye doctor appointments

Release 7 — 3 months, dose 1

2021-04-07

Symptoms: Vision loss from uveitis and latent tuberculosis in my left eye. Redness and mild tenderness in left eye. I believe vaccine caused my body to attack problems that were dormant

Healthcare visit (other): Appointment with a uveitis specialist at (b)(6). Also infectious disease specialist in (b)(6)

redacted (b)(6)

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	✓	✓	✓
HCVO	Specialist consultation	○	○	○
HCVO	Unevaluable event	✓	✓	✓
SD	Blindness	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Latent tuberculosis	✓	✓	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Uveitis	✓	✓	✓
SRO	Eye pain	✓	✓	✓

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

Possible VAERS report