3CY-15195-02657

2 vaccinations 14 coded responses 22 check-ins 14 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 115 / NY
Registered: 2021-02-13

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

2021-02-12
Dose 1 — Moderna
2021-02-13
Registered in v-safe
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pruritus — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Mild itching under my arm and behind shoulder. Completely Exhausted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Very tired

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: Muscle spasms, Skin burning sensation — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Muscle spasms and occasional burning feeling on skin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Dizziness last night and this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine, Movement disorder — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I can't move my arm. Severe migraine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Brucellosis, Erythema, Pre-existing disease, Skin burning sensation — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: L side of face & L eye became very red. Also, sporadic sensation of burning on skin . I have a genetic inflammatory disease - familial Mediterranean fever. I take 2 colchicine daily. Possibly this information may be useful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Inflammation, Limb discomfort, Rash — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Rash is sporadic. Inflammatory response is throughout body. Muscle and joints. My legs feel very heavy. My left shoulder is painful . Thus far discomfort hasn't eased. I feel there may be a connection between familial Mediterranean fever, a genetic inflammatory disease I have suffered with since birth and the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Skin burning sensation — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Burning sensation on skin continues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 7, dose 2
MedDRA: Fatigue, Visual impairment — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Vision changes, extreme exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 14, dose 2
MedDRA: Pruritus, Rash, Rash erythematous, Rash papular — Feeling: Fair

Free text: A few raises bumps on my Arm with sensation of itching. It started a few days ago. They are hard, small and slightly red. Same side as vaccination. If they remain i will have my dr take a look when i see him Monday. Left side of neck as well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — day 21, dose 2
MedDRA: Muscle spasms, Pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Joint pain worse. Muscle Spasms · Healthcare visit (other): Spinal MRI. Joint Pain is worse since vaccination, however results of prior mri done before vaccination has not changed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
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)
2021-04-09
Survey response — day 28, dose 2
MedDRA: Burning sensation, Condition aggravated, Dermatitis, Dry skin, Erythema, Office visit, Pre-existing disease, Rash papular, Skin burning sensation, Skin irritation — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Worsening sensation of constant skin irritation & burning. Neck now has bands of red, inflamed,and burning skin that feels burned to the touch as well. Left arm has a few small raised red, dry skin patches. · Healthcare visit (other): Dermatologist

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

1 call case(s)
2021-04-16
Survey response — day 35, dose 2
MedDRA: Arthralgia, Fatigue, Myalgia, Rash, Skin burning sensation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Rash behind my ear where it meets my skull extends in a long band with burning sensation. Muscle and joint pain remain the same. Exhaustion. · Healthcare visit (other): I saw a dermatologist for the 2nd time. Rash on my neck is getting better however rash behind my ear had become worse. I was given rx lotion and it is improving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Eye pain, Eye swelling, Myalgia, Office visit, Pain, Pain in extremity, Rash, Skin burning sensation, Visual impairment — 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: Rash spread, joint & muscle pain are worse. Pain i becomes intolerable. Eyes swelk & vision changes are frequent. Muscle pain. Skin is burning. fingertips are sore & gel line they are cut & have been in water but haven't. Pain is throughout bod · Healthcare visit (other): Dermatologist, my personal physician, will see eye Dr again shortly. Eyes pain as well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
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)
2021-06-16
Call 1 — Left Voicemail
2021-06-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Mild itching under my arm and behind shoulder. Completely Exhausted.

2021-02-15

Systemic reaction (other): Very tired

2021-02-16

Systemic reaction (other): Muscle spasms and occasional burning feeling on skin.

2021-02-18

Systemic reaction (other): Dizziness last night and this morning

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): I can't move my arm. Severe migraine.

2021-03-14

Systemic reaction (other): L side of face & L eye became very red. Also, sporadic sensation of burning on skin . I have a genetic inflammatory disease - familial Mediterranean fever. I take 2 colchicine daily. Possibly this information may be useful.

2021-03-17

Systemic reaction (other): Rash is sporadic. Inflammatory response is throughout body. Muscle and joints. My legs feel very heavy. My left shoulder is painful . Thus far discomfort hasn't eased. I feel there may be a connection between familial Mediterranean fever, a genetic inflammatory disease I have suffered with since birth and the vaccination.

2021-03-18

Systemic reaction (other): Burning sensation on skin continues.

Release 6 — day 7, dose 2

2021-03-20

Systemic reaction (other): Vision changes, extreme exhaustion

Release 6 — day 14, dose 2

2021-03-26

Symptoms: A few raises bumps on my Arm with sensation of itching. It started a few days ago. They are hard, small and slightly red. Same side as vaccination. If they remain i will have my dr take a look when i see him Monday. Left side of neck as well.

Release 6 — day 21, dose 2

2021-04-04

Symptoms: Joint pain worse. Muscle Spasms

Healthcare visit (other): Spinal MRI. Joint Pain is worse since vaccination, however results of prior mri done before vaccination has not changed.

Release 7 — day 28, dose 2

2021-04-09

Symptoms: Worsening sensation of constant skin irritation & burning. Neck now has bands of red, inflamed,and burning skin that feels burned to the touch as well. Left arm has a few small raised red, dry skin patches.

Healthcare visit (other): Dermatologist

Release 7 — day 35, dose 2

2021-04-16

Symptoms: Rash behind my ear where it meets my skull extends in a long band with burning sensation. Muscle and joint pain remain the same. Exhaustion.

Healthcare visit (other): I saw a dermatologist for the 2nd time. Rash on my neck is getting better however rash behind my ear had become worse. I was given rx lotion and it is improving.

Release 9 — 3 months, dose 2

2021-06-16

Symptoms: Rash spread, joint & muscle pain are worse. Pain i becomes intolerable. Eyes swelk & vision changes are frequent. Muscle pain. Skin is burning. fingertips are sore & gel line they are cut & have been in water but haven't. Pain is throughout bod

Healthcare visit (other): Dermatologist, my personal physician, will see eye Dr again shortly. Eyes pain as well.

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	Eye pain	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pain	✓	✓	✓
HCVO	Pre-existing disease	✓	✓	✓
HCVO	Rash	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Dermatitis	✓	✓	✓
SD	Dry skin	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Eye swelling	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash papular	✓	✓	✓
SD	Skin burning sensation	✓	✓	✓
SD	Skin irritation	✓	✓	✓
SD	Visual impairment	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Brucellosis	○	✓	○
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Movement disorder	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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