5RC-11714-79339

3 vaccinations 5 coded responses 18 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 787 / TX
Registered: 2021-01-16

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-14
Dose 1 — Moderna
2021-01-16
Registered in v-safe
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Ankylosing spondylitis, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: I have ankylosing spondylitis, but pain is worse than normal. Not sure if vaccine or AS.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-21
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Good

Free text: Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Dose 3 — Moderna
2021-11-16
Survey response — 3 months, dose 3
MedDRA: Ankylosing spondylitis, Gait disturbance, Pain, Pre-existing disease, Pyrexia, Tendonitis — Feeling: Good · Be unable to do your normal daily activities

Free text: About 24 hrs after my booster, I had a flare of my ankylosing spondylitis. For the 1st time, my Achilles tendons swelled, and I could barely walk due to the pain. I also got a fever and had body aches for about a 48 hrs.

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Survey response — 6 months, dose 3
MedDRA: Brain fog, Condition aggravated, Fatigue, Migraine, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, 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: Worst ankylosing flare - enthesitis in shoulders and Achilles tendons for 1st time. Brain fog, fatigue, increase in migraine frequency.

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-16
Call 1 — Left Voicemail
2022-08-17
Survey response — 12 months, dose 3
MedDRA: Cerebrospinal fluid leakage, New daily persistent headache, Office visit — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Spinal CSF leak, new daily persistent headache · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2022-08-17
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-08-18
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-10	Moderna
3	2021-08-17	Moderna	No

Call center

4 call center cases

2 successful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): I have ankylosing spondylitis, but pain is worse than normal. Not sure if vaccine or AS.

Release 4 — day 7, dose 2

2021-02-21

Systemic reaction (other): Cough

Release 10 — 3 months, dose 3

2021-11-16

Symptoms: About 24 hrs after my booster, I had a flare of my ankylosing spondylitis. For the 1st time, my Achilles tendons swelled, and I could barely walk due to the pain. I also got a fever and had body aches for about a 48 hrs.

Release 11 — 6 months, dose 3

2022-02-15

Symptoms: Worst ankylosing flare - enthesitis in shoulders and Achilles tendons for 1st time. Brain fog, fatigue, increase in migraine frequency.

Release 12 — 12 months, dose 3

2022-08-17

Symptoms: Spinal CSF leak, new daily persistent headache

Healthcare visit (other): Office visit

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	·	·	✓
SD	Ankylosing spondylitis	·	·	✓
SD	Brain fog	·	·	✓
SD	Cerebrospinal fluid leakage	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Fatigue	·	·	✓
SD	Gait disturbance	·	·	✓
SD	Migraine	·	·	✓
SD	New daily persistent headache	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Tendonitis	·	·	✓
SRO	Ankylosing spondylitis	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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