534-95352-51470
2 vaccinations
3 coded responses
26 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 917 / CA
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-29
Registered in v-safe
-
2021-01-29
Dose 1 — Moderna
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-06
- 2021-02-12
- 2021-02-19
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-06
- 2021-03-12
- 2021-03-19
-
2021-03-27
Survey response — day 28, dose 2MedDRA: Confusional state, Pain in extremity — Feeling: FairFree text: I have felt a bit confused at times and the arm in which the last vaccine was applied is a bit sore.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-10
-
2021-05-29
Survey response — 3 months, dose 2MedDRA: Confusional state, Hallucination — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Starting around May 3rd or so I started Bering confused and This condition worsened with me seeing or thinking I was seeing bugs small creatures like insects or termites I am doing better now, I am not sure if this is associated with the vaccines?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-29
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-30
Survey response — 6 months, dose 2MedDRA: Erythema, Hallucination — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Redness around my nose and cheeks about 45 days ago I was suffering of hallucinations that lasted for about two weeks and then they went away and about a week and a half ago I had a relapse that lasted for three to four days.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-30
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-01
- 2022-03-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna |
Call center
2 call center cases
2 unsuccessful
Free text
Release 6 — day 28, dose 2
Symptoms: I have felt a bit confused at times and the arm in which the last vaccine was applied is a bit sore.
Release 8 — 3 months, dose 2
Symptoms: Starting around May 3rd or so I started Bering confused and This condition worsened with me seeing or thinking I was seeing bugs small creatures like insects or termites I am doing better now, I am not sure if this is associated with the vaccines?
Release 9 — 6 months, dose 2
Symptoms: Redness around my nose and cheeks about 45 days ago I was suffering of hallucinations that lasted for about two weeks and then they went away and about a week and a half ago I had a relapse that lasted for three to four days.
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 | Confusional state | ✓ | ✓ | ✓ |
| SD | Erythema | ✓ | · | ✓ |
| SD | Hallucination | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release