ZJ6-60087-93185

3 vaccinations 10 coded responses 24 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 857 / AZ
Registered: 2021-03-30

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

2021-03-30
Registered in v-safe
2021-03-30
Dose 1 — Moderna
2021-03-30
Health check-in — day 0, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-04-20
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-27
Dose 2 — Moderna
2021-04-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Electric shock sensation, Pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: strange shooting sensations like a lightning storm all around my body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: stomach issues are the worst yet today and i thought the worst was over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-04
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-05-18
Survey response — day 21, dose 2
MedDRA: Fatigue, Palpitations, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: palpitations and fatigue worse. unsure if related. i have eds and autonomic dysfunction.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 28, dose 2
MedDRA: Palpitations, Pre-existing disease — Feeling: Poor · Be unable to work, 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: i have eds and pots and possible multiple system atrophy. have had worse palpitations. unsure if related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-10
Survey response — day 42, dose 2
MedDRA: Adverse reaction, Unevaluable event — Feeling: Poor · Be unable to work, 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: Symptoms: usual symptoms are worse. unclear and doubtful whether this is related to vaccine. · Healthcare visit (other): labs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Call 1 — Left Voicemail
2021-08-14
Dose 3 — Moderna
2021-08-15
Survey response — days 1–6 daily, dose 3
MedDRA: Neuralgia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: interesting nerve pain in the couple hours right after shot

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-16
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-20
Survey response — days 1–6 daily, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: my EDS and POTS have been worse than usual, unsure if related

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Survey response — day 7, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: my usual symptoms are much worse today

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-06
Health check-in — day 21, dose 3
Feeling: Poor

Adult check-in
2021-09-13
Survey response — day 28, dose 3
MedDRA: Fatigue, Musculoskeletal pain, Neuralgia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: worsened fatigue and nerve pain, musculoskeletal pain. hard to say whether this can be attributed to the vaccine. i have a complex medical situation.

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Survey response — day 35, dose 3
MedDRA: Fatigue, Muscle spasms, Neuralgia, Pyrexia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: spasms, nerve pain, fatigue, fever. hard to say if vaccine made these worse.

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Report sent to call center — day 35, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Moderna
2	2021-04-27	Moderna
3	2021-08-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-27	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-18	Successful 2021-09-24	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): strange shooting sensations like a lightning storm all around my body.

2021-05-02

Systemic reaction (other): stomach issues are the worst yet today and i thought the worst was over

Release 8 — day 21, dose 2

2021-05-18

Symptoms: palpitations and fatigue worse. unsure if related. i have eds and autonomic dysfunction.

Release 8 — day 28, dose 2

2021-05-27

Symptoms: i have eds and pots and possible multiple system atrophy. have had worse palpitations. unsure if related.

Release 9 — day 42, dose 2

2021-06-10

Symptoms: usual symptoms are worse. unclear and doubtful whether this is related to vaccine.

Healthcare visit (other): labs

Release 9 — days 1–6 daily, dose 3

2021-08-15

Systemic reaction (other): interesting nerve pain in the couple hours right after shot

2021-08-20

Systemic reaction (other): my EDS and POTS have been worse than usual, unsure if related

Release 9 — day 7, dose 3

2021-08-21

Systemic reaction (other): my usual symptoms are much worse today

Release 9 — day 28, dose 3

2021-09-13

Symptoms: worsened fatigue and nerve pain, musculoskeletal pain. hard to say whether this can be attributed to the vaccine. i have a complex medical situation.

Release 9 — day 35, dose 3

2021-09-18

Symptoms: spasms, nerve pain, fatigue, fever. hard to say if vaccine made these worse.

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	Adverse reaction	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Musculoskeletal pain	·	·	✓
SD	Neuralgia	·	·	✓
SD	Palpitations	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Condition aggravated	✓	·	✓
SRO	Electric shock sensation	✓	✓	✓
SRO	Neuralgia	✓	·	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓

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