36Q-63229-61211
6 vaccinations
5 coded responses
49 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 488 / MI
- Registered
- 2021-02-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Registered in v-safe
-
2021-02-10
Dose 1 — Moderna
- 2021-02-10
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Supraventricular tachycardia — Feeling: GoodFree text: 2 episodes of SVT. Don't think its related. I have a history.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-10
Dose 2 — Moderna
- 2021-03-10
-
2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-17
- 2021-03-24
- 2021-04-02
- 2021-04-08
-
2021-04-14
Survey response — day 35, dose 2MedDRA: Diarrhoea — Feeling: GoodFree text: I've had diarrhea for the last several days without any orher discomfort and for any obvious reason. 2-4 a day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-06-10
- 2021-09-10
-
2021-10-25
Dose 3 — ModernaCo-administered: Flu
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-02
- 2021-11-08
- 2021-11-15
- 2021-11-23
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-03-25
Dose 4 — Moderna
- 2022-04-18
- 2022-04-22
- 2022-04-30
- 2022-05-06
- 2022-06-26
-
2022-09-12
Dose 5 — ModernaCo-administered: Flu
-
2022-09-23
Survey response — 6 months, dose 4MedDRA: Back pain, Manipulation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Back pain for 3 weeks. Dont think its booster related. · Healthcare visit (other): Chiropractic manipulation 7MedDRA releases: 2024-11 · check-in free text available
-
2022-09-23
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-09-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-04
Survey response — day 21, dose 5MedDRA: Office visit, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I do not believe it has anything to do with the vaccines. It started a week before my booster. · Healthcare visit (other): Chiropractic manipulationMedDRA releases: 2024-11 · check-in free text available
-
2022-10-04
Report sent to call center — day 21, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-10-05
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-10
-
2022-10-17
Survey response — day 35, dose 5MedDRA: Atrioventricular block first degree, Blood potassium decreased, Dizziness, Emergency care, Nausea, Orthostatic hypotension, Supraventricular tachycardia, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Yesterday had 4 bouts of SVT which recieve treatment for. Later in the day i stood up and became lightheaded. Bp supine 124/64. Stood up and became lightheaded, nauseous Bp 78/45. Orthostatic hypotension. Went to the ER. K low, 1st degree block. · Healthcare visit (other): Received 1L fluids, oral KMedDRA releases: 2024-11 · check-in free text available
-
2022-10-17
Report sent to call center — day 35, dose 5Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-25
- 2022-12-12
- 2023-03-13
-
2023-04-04
Dose 6 — Moderna
- 2023-05-08
- 2023-05-09
- 2023-05-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-10-25 | Moderna | Flu |
| 4 | 2022-03-25 | Moderna | No |
| 5 | 2022-09-12 | Moderna | Flu |
| 6 | 2023-04-04 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): 2 episodes of SVT. Don't think its related. I have a history.
Release 7 — day 35, dose 2
Symptoms: I've had diarrhea for the last several days without any orher discomfort and for any obvious reason. 2-4 a day.
Release 12 — 6 months, dose 4
Symptoms: Back pain for 3 weeks. Dont think its booster related.
Healthcare visit (other): Chiropractic manipulation 7
Release 12 — day 21, dose 5
Symptoms: I do not believe it has anything to do with the vaccines. It started a week before my booster.
Healthcare visit (other): Chiropractic manipulation
Release 12 — day 35, dose 5
Symptoms: Yesterday had 4 bouts of SVT which recieve treatment for. Later in the day i stood up and became lightheaded. Bp supine 124/64. Stood up and became lightheaded, nauseous Bp 78/45. Orthostatic hypotension. Went to the ER. K low, 1st degree block.
Healthcare visit (other): Received 1L fluids, oral K
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 | Manipulation | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Atrioventricular block first degree | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Blood potassium decreased | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Orthostatic hypotension | · | · | ✓ |
| SD | Supraventricular tachycardia | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Supraventricular tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release