2LL-11468-09148
3 vaccinations
3 coded responses
40 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 496 / MI
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-12
Registered in v-safe
-
2021-02-12
Dose 1 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
-
2021-03-12
Dose 2 — Moderna
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-06-11
- 2021-09-10
-
2021-10-25
Dose 3 — Moderna
- 2021-10-25
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
-
2021-11-08
Survey response — day 14, dose 3MedDRA: Asthenia, Feeling cold, Hypotension, Tremor — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Low blood pressure. Zero energy. Feel like I'm freezing at times. Shake uncontrollably. Going to get a Covid Test at 4:30 today.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-15
Survey response — day 21, dose 3MedDRA: Acute kidney injury, Hospitalisation, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Was hospitalized for acute kidney failure. Got home today to recover. 5 days in hospital. On the mend. Do NOT believe it was do to COVID vaccine. Was tested twice for COVID. Both negative. The shot works!! The hospital was full of COVID patients.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2021-11-16
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-10-25
Survey response — 12 months, dose 3MedDRA: Hospitalisation, Renal failure, Sepsis — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Hospitalized with sepsis and renal failure. All worked out fine. I'm healthy again.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-25
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-10-26
- 2022-10-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-12 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
3 call center cases
1 successful · 2 unsuccessful
Free text
Release 10 — day 14, dose 3
Symptoms: Low blood pressure. Zero energy. Feel like I'm freezing at times. Shake uncontrollably. Going to get a Covid Test at 4:30 today.
Release 10 — day 21, dose 3
Symptoms: Was hospitalized for acute kidney failure. Got home today to recover. 5 days in hospital. On the mend. Do NOT believe it was do to COVID vaccine. Was tested twice for COVID. Both negative. The shot works!! The hospital was full of COVID patients.
Release 12 — 12 months, dose 3
Symptoms: Hospitalized with sepsis and renal failure. All worked out fine. I'm healthy again.
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 | Acute kidney injury | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Feeling cold | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Hypotension | · | · | ✓ |
| SD | Renal failure | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sepsis | · | · | ✓ |
| SD | Tremor | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release