YK9-63129-82540

3 vaccinations 13 coded responses 27 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 785 / TX
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Survey response — day 0, dose 1
MedDRA: Fibromyalgia, Injection site pain, Limb discomfort, Migraine, Nerve injury, Pain, Spinal fusion surgery — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Radiating pain from injection site to shoulder, heaviness of limb, I am a chronic pain patient with fibromyalgia, parasympathetic nerve dysfunction, migraine headaches and a spinal fusion as well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have parasympathetic nerve dysfunction and the vaccine caused a flair up, I also am a chronic pain patient with fibromyalgia and migraine headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Injection site pain, Mobility decreased, Muscle tightness, Muscular weakness, Pain, Peripheral coldness, Pre-existing disease — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The vaccine caused a flair up of my parasympathetic nerve dysfuntion. I lost use of my arm for about 48 hrs, any movement or use of muscles cause extreme pain. My arm was cool to touch, I had radiating pain from the injection site through my shoulder and up my neck. I am a chronic pain patient with fibromyalgia and chronic migraines. I have not had a migraine, but I have noticed the muscles in my shoulder, bicep, and shouder and neck are very tense. Today I have more range of motion, but it herts to use or lift my arm still, though it is worse if I lift it above my breastbone or move it forward/bacward or up, I also lost strength in my arm and hands and it pains me to grasp or lift anything even a phone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Less pain today, but still have loss of strength an pain when using the limb.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Asthenia, Diarrhoea, Injection site pain, Irritable bowel syndrome, Migraine, Pain in extremity — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Started to have a Migraine around 5pm, still very sore at and around injection site and still have loss of strength in myvarm and pain when using it, though less pain today. Started having abdominal cramping and somebdiarrhea today, I have IBS, but have not eaten anything that would have exacerbated it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 7, dose 1
MedDRA: Arthralgia, Asthenia, Fatigue, Injection site pain, Migraine, Myalgia, Pain in extremity — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Had a migraine yesterday, today is a mild residual migraine, but I'm more fatigued and have more muscle and joint aches today. The pain in my arm and injection site is finally mild today, but I still have loss of strength though less and seem to fatigue faster on that arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-26
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
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
2021-04-06
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
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-11
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-23
Survey response — day 21, dose 2
MedDRA: Asthenia, Breast mass, Hypoaesthesia, Mobility decreased, Muscle spasms, Nodule — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Muscle spasm/knot encompassing right shoulder, under scapula/above scapula, and on ribs to side of breast and below armpit. Seems to be pinching a nerve, arm falls asleep, loss of strength, cannot lift weight, and cannot lift higher than 45 degrees

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 35, dose 2
MedDRA: Nervous system disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Apparent nerve issue in the right arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Aura, Diplopia, Dizziness, Migraine — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Migraine aura with dizziness and double vision. Looks like someone threw glitter or jagged different sized pieces of metal in front of my face.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2022-04-02
Survey response — 12 months, dose 2
MedDRA: Abdominal pain, Migraine, Unevaluable event — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Severe/Moderate Abdominal pain since 2/6/22. Migraine headaches are more severe/painful and last longer 24-72 hours · Healthcare visit (other): CT Abdomen, Ultrasound

MedDRA releases: 2024-11 · check-in free text available
2022-04-02
Report sent to call center — 12 months, dose 2
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-08
Call 1 — Could Not Reach Participant
2022-04-11
Call 2 — Could Not Reach Participant
2022-09-23
Dose 3 — Moderna
2022-10-01
Health check-in — day 7, dose 3
Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-10-25
Survey response — day 28, dose 3
MedDRA: Abdominal discomfort, Diarrhoea, Muscle spasms, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Gastrointestinal upset (cramping, pain, diarrhea)

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Survey response — day 35, dose 3
MedDRA: Decreased appetite, Diarrhoea, Gastrointestinal pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Gastrointestinal pain, off/on diarrhea, possible blood in stool, loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Survey response — day 42, dose 3
MedDRA: Abdominal discomfort, Gastrointestinal pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: GI upset and pain/spasms

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2022-09-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-02	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-05

Systemic reaction (other): Radiating pain from injection site to shoulder, heaviness of limb, I am a chronic pain patient with fibromyalgia, parasympathetic nerve dysfunction, migraine headaches and a spinal fusion as well

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): I have parasympathetic nerve dysfunction and the vaccine caused a flair up, I also am a chronic pain patient with fibromyalgia and migraine headaches

2021-03-07

Systemic reaction (other): The vaccine caused a flair up of my parasympathetic nerve dysfuntion. I lost use of my arm for about 48 hrs, any movement or use of muscles cause extreme pain. My arm was cool to touch, I had radiating pain from the injection site through my shoulder and up my neck. I am a chronic pain patient with fibromyalgia and chronic migraines. I have not had a migraine, but I have noticed the muscles in my shoulder, bicep, and shouder and neck are very tense. Today I have more range of motion, but it herts to use or lift my arm still, though it is worse if I lift it above my breastbone or move it forward/bacward or up, I also lost strength in my arm and hands and it pains me to grasp or lift anything even a phone.

2021-03-09

Systemic reaction (other): Less pain today, but still have loss of strength an pain when using the limb.

2021-03-11

Systemic reaction (other): Started to have a Migraine around 5pm, still very sore at and around injection site and still have loss of strength in myvarm and pain when using it, though less pain today. Started having abdominal cramping and somebdiarrhea today, I have IBS, but have not eaten anything that would have exacerbated it.

Release 5 — day 7, dose 1

2021-03-12

Systemic reaction (other): Had a migraine yesterday, today is a mild residual migraine, but I'm more fatigued and have more muscle and joint aches today. The pain in my arm and injection site is finally mild today, but I still have loss of strength though less and seem to fatigue faster on that arm.

Release 7 — day 21, dose 2

2021-04-23

Symptoms: Muscle spasm/knot encompassing right shoulder, under scapula/above scapula, and on ribs to side of breast and below armpit. Seems to be pinching a nerve, arm falls asleep, loss of strength, cannot lift weight, and cannot lift higher than 45 degrees cut off by CDC

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Apparent nerve issue in the right arm

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Migraine aura with dizziness and double vision. Looks like someone threw glitter or jagged different sized pieces of metal in front of my face.

Release 11 — 12 months, dose 2

2022-04-02

Symptoms: Severe/Moderate Abdominal pain since 2/6/22. Migraine headaches are more severe/painful and last longer 24-72 hours

Healthcare visit (other): CT Abdomen, Ultrasound

Release 12 — day 28, dose 3

2022-10-25

Symptoms: Gastrointestinal upset (cramping, pain, diarrhea)

Release 12 — day 35, dose 3

2022-10-28

Symptoms: Gastrointestinal pain, off/on diarrhea, possible blood in stool, loss of appetite

Release 12 — day 42, dose 3

2022-11-04

Symptoms: GI upset and pain/spasms

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	Unevaluable event	·	·	✓
SD	Abdominal discomfort	·	·	✓
SD	Abdominal pain	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Aura	✓	✓	✓
SD	Breast mass	✓	✓	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Diplopia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Gastrointestinal pain	·	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Nervous system disorder	✓	✓	✓
SD	Nodule	✓	✓	✓
SD	Pain	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Fibromyalgia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Irritable bowel syndrome	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Muscle tightness	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nerve injury	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Spinal fusion surgery	✓	✓	✓

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