UKD-25796-16422

4 vaccinations 17 coded responses 41 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 917 / CA
Registered: 2021-04-06

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

2021-03-11
Call 2 — Left Voicemail
2021-04-05
Dose 1 — Moderna
2021-04-06
Registered in v-safe
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety, Tachycardia — Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety, Extrasystoles, Nervousness — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-12
Survey response — 7 day, dose 1
MedDRA: Night sweats — Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-19
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-04-26
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-05-03
Dose 2 — Moderna
2021-05-03
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-10
Health check-in — 7 day, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-17
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-31
Survey response — 28 day, dose 2
MedDRA: Facial paresis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-31
Report sent to call center — 28 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 3 month, dose 2
MedDRA: Injection site pain, Pain — Feeling: Good

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-11-01
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-26
Survey response — 7 day, dose 3
MedDRA: Nervous system disorder — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-12-03
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-02-20
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-03-08
Call 1 — Could Not Reach Participant
2022-05-22
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-11-19
Survey response — 12 month, dose 3
MedDRA: Adverse reaction, Injection site pain, Migraine, Pain, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-11-19
Report sent to call center — 12 month, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-21
Call X — Left Voicemail
2022-11-21
Call 3 — Left Voicemail
2023-04-08
Dose 4 — Moderna
2023-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2023-04-11
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2023-04-13
Survey response — days 1–6 daily, dose 4
MedDRA: Hypopnoea, Insomnia, Pain, Secretion discharge, Snoring, Somnolence, Urine output increased — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-04-14
Survey response — days 1–6 daily, dose 4
MedDRA: Increased viscosity of upper respiratory secretion — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-04-17
Health check-in — 7 day, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2023-04-22
Survey response — 14 day, dose 4
MedDRA: Catarrh, Pain, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-04-29
Survey response — 21 day, dose 4
MedDRA: Abdominal pain upper, Brain fog, Cough, Decreased appetite, Delirium, Fatigue, Lymphadenopathy, Malaise, Nasal congestion, Nasal inflammation, Nausea, Oropharyngeal pain, Pain, Productive cough, Secretion discharge — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2023-04-29
Report sent to call center — 21 day, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-01
Call 3 — Left Voicemail
2023-05-01
Call 1 — Left Voicemail
2023-05-01
Call 1 — Left Voicemail
2023-05-07
Survey response — 28 day, dose 4
MedDRA: Injection site pain, Neuralgia, Pain in extremity — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2023-05-15
Survey response — 35 day, dose 4
MedDRA: Brain fog, Electric shock sensation, Increased upper airway secretion, Increased viscosity of upper respiratory secretion, Insomnia, Muscle spasms, Neuralgia, Tremor — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2023-05-15
Report sent to call center — 35 day, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-16
Call 2 — Left Voicemail
2023-05-16
Call 2 — Left Voicemail
2023-05-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Moderna
2	2021-05-03	Moderna
3	2021-11-19	Moderna	No
4	2023-04-08	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-31	Unsuccessful
2022-11-19	Unsuccessful
2023-04-29	Unsuccessful
2023-05-15	Unsuccessful

Free text

Release 7

Systemic reaction (other): Woke up a bit tachycardic & anxious the last two days

Systemic reaction (other): Ectopic heart beats (last night) with hyper nervousness/ anxious this morning

Systemic reaction (other): Night sweats

Release 8

Systemic reaction (other): Fever

Systemic reaction (other): Constipation (no bowel movement now since getting the shot even tho I am eating & drinking normally)

Systemic reaction (other): Dizzy

Symptoms: Right side of face muscles wont activate (Symptoms mimicking bells palsy) with no prior history of this ever happening

Release 9

Symptoms: Get a twinge of pain every once in awhile where I received the vaccine. Spot is obviously completely healed and fine however, the pain appears and feels like its the day after receiving shot and jolts down my muscle or nerve ending. Then goes away

Release 10

Systemic reaction (other): Nervous system feels off

Release 12

Symptoms: Increased intensity&pain w/chronic migraines. @onset migraine is as bad as the side effect from COVID vaccine. Migraine symptoms never reached this intensity prior to Vax now starts this bad post. Also phantom nerve pain at injection site off&on.

Free-text releases are not linked to a specific 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	Abdominal pain upper	·	·	✓
SD	Adverse reaction	·	·	✓
SD	Brain fog	·	·	✓
SD	Catarrh	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Delirium	·	·	✓
SD	Electric shock sensation	·	·	✓
SD	Facial paresis	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Increased upper airway secretion	·	·	✓
SD	Increased viscosity of upper respiratory secretion	·	·	✓
SD	Injection site pain	✓	·	✓
SD	Insomnia	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Malaise	·	·	✓
SD	Migraine	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nasal inflammation	·	·	✓
SD	Nausea	·	·	✓
SD	Neuralgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	·	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Tremor	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Extrasystoles	✓	✓	✓
SRO	Hypopnoea	·	·	✓
SRO	Increased viscosity of upper respiratory secretion	·	·	✓
SRO	Injection site bruising	·	·	✓
SRO	Injection site discolouration	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Nervous system disorder	·	·	✓
SRO	Nervousness	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Secretion discharge	·	·	✓
SRO	Snoring	·	·	✓
SRO	Somnolence	·	·	✓
SRO	Tachycardia	✓	✓	✓
SRO	Urine output increased	·	·	✓

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