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2GL-11401-54379

2 vaccinations 1 coded response 4 check-ins 1 free-text entry 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
535 / WI
Registered
2021-03-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-27
    Dose 1 — Moderna
  2. 2021-02-26
    Dose 2 — Moderna
  3. 2021-03-02
    Registered in v-safe
  4. 2021-03-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Balance disorder, Fall, Gait disturbance, Headache, Pyrexia — Feeling: Good
    Free text: I wanted to report that I received my second dose of the vaccine February 26. During the night I had fever and headache. I fell because I couldnt function normally. I couldnt hold a paper cup to get a drink. I tried to get back to the bed and fell as I couldnt walk. My husband helped me into the bed. The fever and headache lasted for a couple hours, I was able to sleep about 3hours. When I woke up Icould
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  6. 2021-03-05
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-03-12
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-27Moderna
22021-02-26Moderna

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): I wanted to report that I received my second dose of the vaccine February 26. During the night I had fever and headache. I fell because I couldnt function normally. I couldnt hold a paper cup to get a drink. I tried to get back to the bed and fell as I couldnt walk. My husband helped me into the bed. The fever and headache lasted for a couple hours, I was able to sleep about 3hours. When I woke up Icould

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

FieldPreferred term2021-092023-042024-11
SROBalance disorder ✓ ✓ ✓
SROFall ✓ ✓ ✓
SROGait disturbance ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓

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