ZJR-29369-44958

4 vaccinations 14 coded responses 37 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 988 / WA
Registered: 2021-02-03

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

2021-02-02
Dose 1 — Moderna
2021-02-03
Registered in v-safe
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Survey response — day 14, dose 1
MedDRA: Asthenia, Fatigue, Headache, Influenza like illness, Multiple sclerosis, Pre-existing disease, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: First injection 2/2/2021. Normal reaction. Covid arm began 2/11, flu-like symptoms, burning headache, profound fatigue/weakness, slight fever. Have daily photos. Arm better today, but Covid arm triggered MS exacerbation, which persists.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-02
Dose 2 — Moderna
2021-03-02
Survey response — day 0, dose 2
MedDRA: Headache, Immunisation reaction, Multiple sclerosis relapse, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Had 2nd shot 1/2 hr ago. Got "Covid Arm" 10 days after 1st shot. Have MS & diabetes, both "uncontrolled." Got MS flare-up and still have low-grade headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dyspnoea, Eye pain, Headache, Multiple sclerosis, Ocular discomfort, Oxygen saturation decreased, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Burning headache, pressure behind eyes. Tightness in chest, shortness of breath, oxymeter reading 88. Eye pain. Exacerbated MS symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Site: Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tire easily. Taking it easy, drinking fluids, resting a lot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea, Fatigue, Headache, Insomnia, Nausea, Neuralgia — Feeling: Good · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea

Free text: Wave of nausea, diarrhea, last evening. Strong neuropathic pain last evening, preventing sleep. Was gone by morning. Still have mild headache and fatigue but much better each day..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Headache, Fatigue or tiredness

Free text: No.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Headache, Fatigue or tiredness

Free text: Getting better every day!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 7, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 42, dose 2
MedDRA: Multiple sclerosis, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: I am 71 years old and have advanced MS. I had a powerful reaction to both shots, including a bad case of covid armafter the first shot. I wasn't over the first MS flare-up before the second shot, and I can't seem to recover lost ground.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-31
Survey response — 6 months, dose 2
MedDRA: Insomnia, Pre-existing disease — 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

Free text: Symptoms: Chronic, severe insomnia, began in March. Probably coincidental to date of 2nd vaccination. I have advanced MS (don't take any meds), so it could be related to that. · Healthcare visit (other): Have tried multiple meds, none of which worked. Some increased the insomnia.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Report sent to call center — 6 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

1 call case(s)
2021-11-12
Dose 3 — Moderna
2021-12-15
Call 1 — Left Voicemail
2022-03-02
Health check-in — 12 months, dose 2
Feeling: Poor

Adult check-in
2022-04-21
Dose 4 — Moderna
2022-04-25
Survey response — days 1–6 daily, dose 4
MedDRA: Cognitive disorder, Disorientation, Multiple sclerosis, Pre-existing disease, Psychiatric symptom — Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diagnosed with Multiple Sclerosis 1984. Flares-up with each Covid shot. Cognitive dysfunction this time, with symptoms similar to early dementia (disorientation, etc). Some improvement now, but not gone yet.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-27
Survey response — days 1–6 daily, dose 4
MedDRA: Multiple sclerosis, Pre-existing disease, Vaccine positive rechallenge — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I'm a 72 yo woman. I have had MS for more than four decades. Not taking any medications for it. All of the shots have triggered MS flare-ups, which linger. I'm grateful for the shots, though!

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-21
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-02	Moderna
3	2021-11-12	Moderna	No
4	2022-04-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-31	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): brain fog

Release 4 — day 14, dose 1

2021-02-16

Symptoms: First injection 2/2/2021. Normal reaction. Covid arm began 2/11, flu-like symptoms, burning headache, profound fatigue/weakness, slight fever. Have daily photos. Arm better today, but Covid arm triggered MS exacerbation, which persists.

Release 4 — day 0, dose 2

2021-03-02

Systemic reaction (other): Had 2nd shot 1/2 hr ago. Got "Covid Arm" 10 days after 1st shot. Have MS & diabetes, both "uncontrolled." Got MS flare-up and still have low-grade headache.

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Burning headache, pressure behind eyes. Tightness in chest, shortness of breath, oxymeter reading 88. Eye pain. Exacerbated MS symptoms.

2021-03-04

Systemic reaction (other): Tire easily. Taking it easy, drinking fluids, resting a lot.

2021-03-06

Systemic reaction (other): Wave of nausea, diarrhea, last evening. Strong neuropathic pain last evening, preventing sleep. Was gone by morning. Still have mild headache and fatigue but much better each day..

2021-03-07

Systemic reaction (other): No.

2021-03-08

Systemic reaction (other): Getting better every day!

Release 5 — day 7, dose 2

2021-03-09

Systemic reaction (other): No.

Release 7 — day 42, dose 2

2021-04-13

Symptoms: I am 71 years old and have advanced MS. I had a powerful reaction to both shots, including a bad case of covid armafter the first shot. I wasn't over the first MS flare-up before the second shot, and I can't seem to recover lost ground.

Release 9 — 6 months, dose 2

2021-08-31

Symptoms: Chronic, severe insomnia, began in March. Probably coincidental to date of 2nd vaccination. I have advanced MS (don't take any meds), so it could be related to that.

Healthcare visit (other): Have tried multiple meds, none of which worked. Some increased the insomnia.

Release 11 — days 1–6 daily, dose 4

2022-04-25

Systemic reaction (other): Diagnosed with Multiple Sclerosis 1984. Flares-up with each Covid shot. Cognitive dysfunction this time, with symptoms similar to early dementia (disorientation, etc). Some improvement now, but not gone yet.

2022-04-27

Systemic reaction (other): I'm a 72 yo woman. I have had MS for more than four decades. Not taking any medications for it. All of the shots have triggered MS flare-ups, which linger. I'm grateful for the shots, though!

Release 11 — day 7, dose 4

2022-04-28

Systemic reaction (other): None

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	Insomnia	✓	·	✓
SD	Asthenia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Insomnia	✓	·	✓
SD	Multiple sclerosis	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cognitive disorder	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Disorientation	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Multiple sclerosis	✓	✓	✓
SRO	Multiple sclerosis relapse	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Oxygen saturation decreased	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Psychiatric symptom	·	·	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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