4R3-32480-18610
1 vaccination
3 coded responses
8 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 894 / NV
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Dose 1 — Moderna
-
2021-01-06
Registered in v-safe
-
2021-01-06
Survey response — days 1–6 daily, dose 1MedDRA: Gait inability, Tremor — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesFree text: After the shot, I was shaking and felt like I couldn't walk.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-06
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
-
2021-01-07
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-07
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
-
2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Muscular weakness — Feeling: Fair · Site: Pain, Redness, 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 activitiesFree text: I feel exhausted and very weak at the knees.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-08
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-10
-
2021-01-11
Survey response — days 1–6 daily, dose 1MedDRA: Aphasia, Chills, Crying, Dry mouth, Erythema, Fear, Headache, Heart rate increased, Immediate post-injection reaction, Loss of control of legs, Medical observation, Nausea, Nervous system disorder, Salivary hypersecretion, Spinal pain, Tremor — Feeling: Good · Fatigue or tirednessFree text: I would like to report what happened to me. I had the vaccination on Tuesday the 5th at 2:20. Within 10 minutes my mouth started producing s extra saliva and I began feeling nauseous. My mouth felt like I was getting cotton mouth. My face started getting red and neck also. My heart rate began elevating. The doctor took my vitals. I then started getting the chills. I stayed for about 2 hours. The doctor and nurse walked me out and got me to my husband and daughter. They also gave me a Benadryl pill but wasn't working quick enough so they gave me a Benadryl shot. When walking out, felt a sharp pain in my head down to the back of my spine. My legs collapsed and I couldn't talk. I began crying. I was also shaking uncontrollably. My family eventually got me home into bed and it took four days for me to feel normal. It was very scary. I am an extremely fit person and I felt it affected my nervous system. It was very scary!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-12
- 2021-01-19
- 2022-01-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna |
Call center
3 call center cases
3 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): After the shot, I was shaking and felt like I couldn't walk.
Systemic reaction (other): I feel exhausted and very weak at the knees.
Systemic reaction (other): I would like to report what happened to me. I had the vaccination on Tuesday the 5th at 2:20. Within 10 minutes my mouth started producing s extra saliva and I began feeling nauseous. My mouth felt like I was getting cotton mouth. My face started getting red and neck also. My heart rate began elevating. The doctor took my vitals. I then started getting the chills. I stayed for about 2 hours. The doctor and nurse walked me out and got me to my husband and daughter. They also gave me a Benadryl pill but wasn't working quick enough so they gave me a Benadryl shot. When walking out, felt a sharp pain in my head down to the back of my spine. My legs collapsed and I couldn't talk. I began crying. I was also shaking uncontrollably. My family eventually got me home into bed and it took four days for me to feel normal. It was very scary. I am an extremely fit person and I felt it affected my nervous system. It was very scary!
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 |
|---|---|---|---|---|
| SRO | Aphasia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Crying | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Fear | ✓ | ✓ | ✓ |
| SRO | Gait inability | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Loss of control of legs | ✓ | ✓ | ✓ |
| SRO | Medical observation | ✓ | ✓ | ✓ |
| SRO | Muscular weakness | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Nervous system disorder | ✓ | ✓ | ✓ |
| SRO | Salivary hypersecretion | ✓ | ✓ | ✓ |
| SRO | Spinal pain | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release