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YJ9-23017-32551

1 vaccination 3 coded responses 4 check-ins 3 free-text entries 1 call case
Sex
Female
Age at first dose
41-45
ZIP prefix
354 / AL
Registered
2021-08-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
RU8-27221-05480 Child or adolescent in my care · Female · 2021-08-02

Timeline

  1. 2021-07-31
    Dose 1 — Moderna
  2. 2021-08-02
    Registered in v-safe
  3. 2021-08-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache, Muscle spasms, Muscle tightness, Muscle twitching, Tic — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: I've gad a headache every day since getting the vaccine, but even more concerning, ive had extreme muscle tension and spasms in the back of my neck into the base of my head. I have this twitching sensation (tick), of some kind that has been bothersom
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  4. 2021-08-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Axillary pain, Head discomfort, Muscle discomfort, Musculoskeletal discomfort, Nervousness — Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities
    Free text: I continue to have an uncomfortable feeling in my neck muscle and pressure in the base of my head and left shoulder. I'm nervous feeling inside to the point it becomes very bothersome. I woke up this morning with pain under my left armpit as well.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  5. 2021-08-14
    Survey response — day 14, dose 1
    MedDRA: Blood urine present, Headache, Medical counselling, Muscle twitching, Neck pain, Nervous system disorder, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: I'm still having muscle twitching, nerve issues and some pain running up the back of my neck into the vase of my head. Newest issue is I've had a severe urinary tract infection with blood. This problem occurred about 3 weeks ago. I'm on antibiotics. · Healthcare visit (other): Dr. called in medicine based on ky symptoms
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  6. 2021-08-14
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  7. 2021-08-21
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  8. 2021-08-23
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-07-31Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-08-14 Successful
2021-08-23
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-02

Systemic reaction (other): I've gad a headache every day since getting the vaccine, but even more concerning, ive had extreme muscle tension and spasms in the back of my neck into the base of my head. I have this twitching sensation (tick), of some kind that has been bothersom cut off by CDC

2021-08-04

Systemic reaction (other): I continue to have an uncomfortable feeling in my neck muscle and pressure in the base of my head and left shoulder. I'm nervous feeling inside to the point it becomes very bothersome. I woke up this morning with pain under my left armpit as well. cut off by CDC

Release 9 — day 14, dose 1

2021-08-14

Symptoms: I'm still having muscle twitching, nerve issues and some pain running up the back of my neck into the vase of my head. Newest issue is I've had a severe urinary tract infection with blood. This problem occurred about 3 weeks ago. I'm on antibiotics. cut off by CDC
Healthcare visit (other): Dr. called in medicine based on ky symptoms

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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling ✓ · ✓
SDBlood urine present ✓ · ✓
SDHeadache ✓ · ✓
SDMuscle twitching ✓ · ✓
SDNeck pain ✓ · ✓
SDNervous system disorder ✓ · ✓
SDUrinary tract infection ✓ · ✓
SROAxillary pain ✓ · ✓
SROHead discomfort ✓ · ✓
SROHeadache ✓ · ✓
SROMuscle discomfort ✓ · ✓
SROMuscle spasms ✓ · ✓
SROMuscle tightness ✓ · ✓
SROMuscle twitching ✓ · ✓
SROMusculoskeletal discomfort ✓ · ✓
SRONervousness ✓ · ✓
SROTic ✓ · ✓

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