YZJ-26269-18031

3 vaccinations 10 coded responses 39 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 559 / MN
Registered: 2021-02-26

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-02-25
Dose 1 — Moderna
2021-02-26
Registered in v-safe
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Injection site erythema — Feeling: Good · Be unable to do your normal daily activities

Free text: Diarrhea Redness over injection area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 28, dose 1
MedDRA: Eye pain, Eye swelling, Ocular hyperaemia — Feeling: Good

Free text: Left eyelid red, very swollen and sore for past 4 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Dose 2 — Moderna
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Muscle or body aches

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-28
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very sore armpit

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen painful armpit of injected arm

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema, Tenderness — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Continuing painful tenderness with swelling in my armpit.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Armpit less sore and less swollen.

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Good

Free text: Armpit still slightly sore but much better than previous.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Survey response — day 14, dose 3
MedDRA: Lacrimation increased, Rhinorrhoea, Sneezing — Feeling: Good

Free text: Frequent sneezing, very runny nose, watery eyes.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 21, dose 3
MedDRA: Herpes simplex — Feeling: Good

Free text: Herpes simplex1 outbreak in both nares.

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Cataract operation, Rotator cuff syndrome, Tendonitis — 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: Rotator cuff tear and tendinitis Cataract surgeries

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
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)
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-31	Moderna
3	2021-10-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-10-28	Unsuccessful

Free text

Release 5 — day 14, dose 1

2021-03-11

Symptoms: Diarrhea Redness over injection area

Release 6 — day 28, dose 1

2021-03-25

Symptoms: Left eyelid red, very swollen and sore for past 4 days

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): Very sore armpit

2021-10-30

Systemic reaction (other): Swollen painful armpit of injected arm

2021-10-31

Systemic reaction (other): Continuing painful tenderness with swelling in my armpit.

2021-11-01

Systemic reaction (other): Armpit less sore and less swollen.

2021-11-02

Systemic reaction (other): Armpit still slightly sore but much better than previous.

Release 10 — day 14, dose 3

2021-11-11

Symptoms: Frequent sneezing, very runny nose, watery eyes.

Release 10 — day 21, dose 3

2021-11-18

Symptoms: Herpes simplex1 outbreak in both nares.

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: Rotator cuff tear and tendinitis Cataract surgeries

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
SD	Cataract operation	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Eye swelling	✓	✓	✓
SD	Herpes simplex	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Lacrimation increased	·	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Rotator cuff syndrome	·	·	✓
SD	Sneezing	·	·	✓
SD	Tendonitis	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Oedema	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Tenderness	·	·	✓

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