YXD-15830-13695

5 vaccinations 18 coded responses 39 check-ins 18 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 968 / HI
Registered: 2021-03-30

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-22
Dose 1 — Moderna
2021-03-30
Registered in v-safe
2021-03-30
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-05
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-12
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-19
Survey response — day 0, dose 2
MedDRA: Muscle twitching — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Twitching?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle twitching — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Twitching?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Paraesthesia — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to work

Free text: Tingling, a bit of dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Slight chest pain on /off -muscle?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness

Free text: Migraine on right side, vaccination side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Terrible migraine on shot side worse than yesterday. Took Prescription and stayed in bed. Interaction with vaccine?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — day 35, dose 2
MedDRA: Migraine, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: I suffer from severe migraine for many years but prescription normally works. Since Mordena vaccine, my migraine conditions has gotten worse and get more often. Sometimes I have to stay in bed,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-19
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-20
Survey response — 6 months, dose 2
MedDRA: Asthenia, Condition aggravated, Pain, Pre-existing disease, Pruritus — Feeling: Fair

Free text: Not sure but feel weaker and varicose veins got inflamed more with some itchy pains etc

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Dose 3 — Moderna
2022-04-19
Dose 4 — Moderna
2022-04-19
Survey response — day 0, dose 4
MedDRA: Feeling hot, Mobility decreased, Peripheral swelling — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Warm swelling also in Arm, hard to raise left arm

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Survey response — days 1–6 daily, dose 4
MedDRA: Decreased appetite, Disturbance in attention, Pain, Self-medication — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite. Took Tylenol twice for pains during night. Lack of concentrations, clouded mind?

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Survey response — days 1–6 daily, dose 4
MedDRA: Disturbance in attention, Immunisation reaction, Vaccine positive rechallenge — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: It looks like I started having moderna arm aka covid arm like I had after my 1st moderna vaccine shot. Hard to concentrate anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — days 1–6 daily, dose 4
MedDRA: Asthenia, Varicose vein, Vascular pain — Feeling: Poor · Site: Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: It may not related but my right varicose vein are very pain and weak

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Survey response — days 1–6 daily, dose 4
MedDRA: Immunisation reaction, Vascular pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to work or attend school

Free text: Comparing my 1st moderna vaccine, it's very mild form of Moderna arm I have this time. Pains in Varicose veins are a bit better today.

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-04-26
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-05-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-10
Survey response — day 21, dose 4
MedDRA: Arthralgia, Arthritis, Condition aggravated, Migraine, Pre-existing disease — Feeling: Fair · Be unable to work or attend school

Free text: I suffer from Migraines, joint pains(arthritis) , varicose veins but they got worsened I don't know if they are related effects with vaccines

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-11-07
Dose 5 — Moderna
2022-11-08
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-09
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-11-10
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog — Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cloudy /foggy brain

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cloudy brain

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog — Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness

Free text: Cloudy brain

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Survey response — day 7, dose 5
MedDRA: Pre-existing disease — Feeling: Poor · Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: It may not be related to the bivalent booster as it has happened before. But sudden sweating followed by a bit of dizziness and felt nauseated and weakness. All okay now

MedDRA releases: 2024-11 · check-in free text available
2022-11-21
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-11-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-07
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna
3	2021-11-17	Moderna	No
4	2022-04-19	Moderna	No
5	2022-11-07	Moderna	No

Free text

Release 7 — day 0, dose 2

2021-04-19

Systemic reaction (other): Twitching?

Release 7 — days 1–6 daily, dose 2

2021-04-20

Systemic reaction (other): Twitching?

2021-04-21

Systemic reaction (other): Tingling, a bit of dizziness

2021-04-23

Systemic reaction (other): Slight chest pain on /off -muscle?

2021-04-24

Systemic reaction (other): Migraine on right side, vaccination side

2021-04-25

Systemic reaction (other): Terrible migraine on shot side worse than yesterday. Took Prescription and stayed in bed. Interaction with vaccine?

Release 8 — day 35, dose 2

2021-05-25

Symptoms: I suffer from severe migraine for many years but prescription normally works. Since Mordena vaccine, my migraine conditions has gotten worse and get more often. Sometimes I have to stay in bed,

Release 10 — 6 months, dose 2

2021-10-20

Symptoms: Not sure but feel weaker and varicose veins got inflamed more with some itchy pains etc

Release 11 — day 0, dose 4

2022-04-19

Systemic reaction (other): Warm swelling also in Arm, hard to raise left arm

Release 11 — days 1–6 daily, dose 4

2022-04-20

Systemic reaction (other): Loss of appetite. Took Tylenol twice for pains during night. Lack of concentrations, clouded mind?

2022-04-21

Systemic reaction (other): It looks like I started having moderna arm aka covid arm like I had after my 1st moderna vaccine shot. Hard to concentrate anxiety

2022-04-22

Systemic reaction (other): It may not related but my right varicose vein are very pain and weak

2022-04-23

Systemic reaction (other): Comparing my 1st moderna vaccine, it's very mild form of Moderna arm I have this time. Pains in Varicose veins are a bit better today.

Release 11 — day 21, dose 4

2022-05-10

Symptoms: I suffer from Migraines, joint pains(arthritis) , varicose veins but they got worsened I don't know if they are related effects with vaccines

Release 12 — days 1–6 daily, dose 5

2022-11-10

Systemic reaction (other): Cloudy /foggy brain

2022-11-12

Systemic reaction (other): Cloudy brain

2022-11-13

Systemic reaction (other): Cloudy brain

Release 12 — day 7, dose 5

2022-11-16

Systemic reaction (other): It may not be related to the bivalent booster as it has happened before. But sudden sweating followed by a bit of dizziness and felt nauseated and weakness. All okay now

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
SD	Arthralgia	·	·	✓
SD	Arthritis	·	·	✓
SD	Asthenia	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Migraine	✓	✓	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Disturbance in attention	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling hot	·	·	✓
SRO	Immunisation reaction	·	·	✓
SRO	Migraine	✓	✓	✓
SRO	Mobility decreased	·	·	✓
SRO	Muscle twitching	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral swelling	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Vaccine positive rechallenge	·	·	✓
SRO	Varicose vein	·	·	✓
SRO	Vascular pain	·	·	✓

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