Z75-13000-72113

5 vaccinations 18 coded responses 38 check-ins 18 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 921 / CA
Registered: 2021-03-23

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

2021-03-23
Registered in v-safe
2021-03-23
Dose 1 — Moderna
2021-03-23
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Free text: Chronic migraines, fibromyalgia-moderate symptoms present before vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Fibromyalgia and chronic migraines, symptoms fairly typical

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Migraine, Pre-existing disease — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Fibromyalgia, chronic migraines seem to be flaring post-vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Migraine, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Fibromyalgia, chronic migraines flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Fibromyalgia, Migraine — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Fibromyalgia, chronic migraines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Fibromyalgia, Migraine, Pre-existing disease, Spinal pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain in the spine, fibromyalgia and chronic migraines flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 7, dose 1
MedDRA: Migraine, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Fibromyalgia, chronic migraines (flare abating)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-13
Survey response — day 21, dose 1
MedDRA: Arthritis, Migraine, Pre-existing disease — Feeling: Fair · 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: Arthritis and migraine flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 28, dose 1
MedDRA: Migraine — Feeling: Poor · 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: Migraines have been more frequent and less responsive to medications

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 28, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-26
Dose 2 — Moderna
2021-04-26
Survey response — day 0, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: All symptoms from waiting in line for almost 2 hours and pre-existing conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Oropharyngeal pain, Pre-existing disease, Tachycardia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Dry cough, tachycardia, possible potassium deficiency (underlying renal tubule disorder, possibly aggravated by vaccine response?), fibromyalgia symptom flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Migraine, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Fibromyalgia and migraines flare from shot waning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Chronic condition flares largely subsiding. Headaches remain somewhat worse than normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 7, dose 2
MedDRA: Headache, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Headaches still above my normal, but fibromyalgia is returning to my non-flare normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-24
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-26
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Musculoskeletal stiffness, Pain in extremity, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Stiffness/pain in toes, possibly related to increased immune activity post-vaccination (w/prior history of autoimmune disease that had been largely in remission). Rheumatologist prescribed hydroxychloroquine, which had worked with prior MCTD flares

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-26
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-03
Call 1 — Left Voicemail
2021-10-27
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-17
Dose 3 — Moderna
2022-04-12
Dose 4 — Moderna
2022-04-28
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-28
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-05
Survey response — day 21, dose 4
MedDRA: Cough, Paranasal sinus discomfort, Rhinorrhoea, SARS-CoV-2 test negative, Sinus pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sinus pressure and pain, runny nose, cough (negative home COVID tests)

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-26
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-12
Survey response — 3 months, dose 4
MedDRA: Chest discomfort, Cough, Oropharyngeal pain, Tachycardia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, chest heaviness, cough, tachycardia

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Dose 5 — Moderna
Co-administered: Flu
2022-10-11
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-17
Survey response — day 21, dose 5
MedDRA: Fatigue, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore throat, fatigue, pain

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-10-31
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-07
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-26
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-03-27
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Moderna
2	2021-04-26	Moderna
3	2021-11-17	Moderna	No
4	2022-04-12	Moderna	No
5	2022-09-26	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-04-13	Unsuccessful
2021-04-22	Unsuccessful
2021-07-26	Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-03-23

Systemic reaction (other): Chronic migraines, fibromyalgia-moderate symptoms present before vaccine

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): Fibromyalgia and chronic migraines, symptoms fairly typical

2021-03-25

Systemic reaction (other): Fibromyalgia, chronic migraines seem to be flaring post-vaccination

2021-03-26

Systemic reaction (other): Fibromyalgia, chronic migraines flare

2021-03-27

Systemic reaction (other): Fibromyalgia, chronic migraines

2021-03-28

Systemic reaction (other): Pain in the spine, fibromyalgia and chronic migraines flare

Release 6 — day 7, dose 1

2021-03-30

Systemic reaction (other): Fibromyalgia, chronic migraines (flare abating)

Release 7 — day 21, dose 1

2021-04-13

Symptoms: Arthritis and migraine flare

Release 7 — day 28, dose 1

2021-04-22

Symptoms: Migraines have been more frequent and less responsive to medications

Release 8 — day 0, dose 2

2021-04-26

Systemic reaction (other): All symptoms from waiting in line for almost 2 hours and pre-existing conditions

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): Dry cough, tachycardia, possible potassium deficiency (underlying renal tubule disorder, possibly aggravated by vaccine response?), fibromyalgia symptom flare

2021-05-01

Systemic reaction (other): Fibromyalgia and migraines flare from shot waning

2021-05-02

Systemic reaction (other): Chronic condition flares largely subsiding. Headaches remain somewhat worse than normal

Release 8 — day 7, dose 2

2021-05-03

Systemic reaction (other): Headaches still above my normal, but fibromyalgia is returning to my non-flare normal

Release 9 — 3 months, dose 2

2021-07-26

Symptoms: Stiffness/pain in toes, possibly related to increased immune activity post-vaccination (w/prior history of autoimmune disease that had been largely in remission). Rheumatologist prescribed hydroxychloroquine, which had worked with prior MCTD flares cut off by CDC

Release 11 — day 21, dose 4

2022-05-05

Symptoms: Sinus pressure and pain, runny nose, cough (negative home COVID tests)

Release 12 — 3 months, dose 4

2022-07-12

Symptoms: Sore throat, chest heaviness, cough, tachycardia

Release 12 — day 21, dose 5

2022-10-17

Symptoms: Sore throat, fatigue, pain

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	Arthritis	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Condition aggravated	✓	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Migraine	✓	✓	✓
SD	Musculoskeletal stiffness	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus pain	·	·	✓
SD	Tachycardia	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Fibromyalgia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Spinal pain	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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