2XS-29239-21534

1 vaccination 5 coded responses 13 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 670 / KS
Registered: 2021-03-24

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

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Moderna
2021-03-24
Survey response — day 0, dose 1
MedDRA: Chest pain, Dizziness, Paraesthesia, Paraesthesia oral — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness, face and lip tingling, chest pain (right side)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Headache, Nausea

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Headache, Nausea

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-04-02
Health check-in — day 7, dose 1
Feeling: Good · Fever · Chills, Nausea

Adult check-in
2021-04-07
Survey response — day 14, dose 1
MedDRA: Chills, Fatigue, Headache, Hyperhidrosis, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headache increased significantly. Chills and sweating profusely. Extreme fatigue and body aches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-28
Survey response — day 35, dose 1
MedDRA: Facial paralysis, Headache, Hospitalisation, Movement disorder — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Admitted to hospital for stroke like symptoms. Droopy face. Unable to move right arm/leg. Severe headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 35, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-05
Survey response — day 42, dose 1
MedDRA: Disturbance in attention, Migraine — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Severe migraines, wont subside. Difficult to concentrate.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 42, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-22
Survey response — 6 months, dose 1
MedDRA: Adverse reaction, Cerebrovascular accident, Hemiplegic migraine, Immediate post-injection reaction, Rehabilitation therapy — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Hemiplegic migraines (mimicking stroke) less than a month after initial COVID vaccine most likely due to severe reaction I had within 15 minutes of initial vaccination. Onset in April. Have had at least 6 episodes since. · Healthcare visit (other): Stroke rehab

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-23
Call 1 — Left Voicemail
2021-09-24
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-24

Systemic reaction (other): Dizziness, face and lip tingling, chest pain (right side)

Release 7 — day 14, dose 1

2021-04-07

Symptoms: Headache increased significantly. Chills and sweating profusely. Extreme fatigue and body aches.

Release 8 — day 35, dose 1

2021-04-28

Symptoms: Admitted to hospital for stroke like symptoms. Droopy face. Unable to move right arm/leg. Severe headache.

Release 8 — day 42, dose 1

2021-05-05

Symptoms: Severe migraines, wont subside. Difficult to concentrate.

Release 9 — 6 months, dose 1

2021-09-22

Symptoms: Hemiplegic migraines (mimicking stroke) less than a month after initial COVID vaccine most likely due to severe reaction I had within 15 minutes of initial vaccination. Onset in April. Have had at least 6 episodes since.

Healthcare visit (other): Stroke rehab

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	Cerebrovascular accident	·	·	✓
HCVO	Rehabilitation therapy	·	·	✓
SD	Adverse reaction	·	·	✓
SD	Chills	✓	✓	✓
SD	Disturbance in attention	✓	✓	✓
SD	Facial paralysis	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hemiplegic migraine	·	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Immediate post-injection reaction	·	·	✓
SD	Migraine	✓	✓	✓
SD	Movement disorder	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓

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