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4XL-29484-74778

1 vaccination 3 coded responses 8 check-ins 3 free-text entries 1 call case
Sex
Female
Age at first dose
36-40
ZIP prefix
600 / IL
Registered
2021-04-10
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-26
    Dose 1 — Moderna
  2. 2021-04-10
    Registered in v-safe
  3. 2021-04-10
    Survey response — day 14, dose 1
    MedDRA: Dysstasia, Emergency care, Presyncope — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: Since the the day after my shot (3/27/21), I have had reoccurring near syncope episodes. They have been so debilitating that I went to the Emergency Room and had to move in with my parents because I cant stand long enough to make food for myself.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-16
    Survey response — day 21, dose 1
    MedDRA: Hypotension, Muscular weakness, Vertigo — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit
    Free text: I still have weakness in my limbs. But have now have low blood pressure, which started after the shot, and vertigo. I still cant stand long enough to make food for myself or shower alone.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-16
    Report sent to call center — day 21, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-04-23
    Health check-in — day 28, dose 1
    Feeling: Poor
    Adult check-in
  7. 2021-04-30
    Health check-in — day 35, dose 1
    Feeling: Fair
    Adult check-in
  8. 2021-05-07
    Health check-in — day 42, dose 1
    Feeling: Fair
    Adult check-in
  9. 2021-06-25
    Survey response — 3 months, dose 1
    MedDRA: Rash — Feeling: Fair
    Free text: Rash on my left arm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-09-24
    Health check-in — 6 months, dose 1
    Feeling: Fair
    Adult check-in
  11. 2021-12-15
  12. 2022-03-26
    Health check-in — 12 months, dose 1
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-26Moderna

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-10

Symptoms: Since the the day after my shot (3/27/21), I have had reoccurring near syncope episodes. They have been so debilitating that I went to the Emergency Room and had to move in with my parents because I cant stand long enough to make food for myself.

Release 7 — day 21, dose 1

2021-04-16

Symptoms: I still have weakness in my limbs. But have now have low blood pressure, which started after the shot, and vertigo. I still cant stand long enough to make food for myself or shower alone.

Release 9 — 3 months, dose 1

2021-06-25

Symptoms: Rash on my left arm.

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
SDDysstasia ✓ ✓ ✓
SDEmergency care ✓ ✓ ✓
SDHypotension ✓ ✓ ✓
SDMuscular weakness ✓ ✓ ✓
SDPresyncope ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDVertigo ✓ ✓ ✓

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