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5HN-18550-14380

2 vaccinations 8 coded responses 10 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
958 / CA
Registered
2021-05-04
Relationship
Self
Race
Multiracial
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-05-04
    Registered in v-safe
  2. 2021-05-04
    Dose 1 — Moderna
  3. 2021-05-04
    Survey response — day 0, dose 1
    MedDRA: Asthma, Dyspnoea — Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Shortness of breath- Asthmatic on nebulizer
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-05-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Asthma, Delirium, Dyspnoea, Pre-existing disease, Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: During the night I had an event that made me feel like a high fever and delirium and/or onset of bad asthma attack. Event like none other. Shortness of breath and panic
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: First ever vaccine that I had side effects from
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: Anxiety, Dyspnoea — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Still unnecessarily anxious and short of breath
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: General symptom, Malaise — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: I believe I may be a long hauler undiagnosed as I have been deathly ill with Covid symptoms all year
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Diplopia, Dyspnoea, Headache — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Shortness of breath continual- eyesight still momentary double-vision and headaches pretty unbearable
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-11
    Survey response — day 7, dose 1
    MedDRA: Dyspnoea — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Still have extreme shortness of breath
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-18
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  11. 2021-05-26
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  12. 2021-06-01
    Dose 2 — Moderna
  13. 2021-06-01
    Survey response — day 0, dose 2
    MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: 12 hours after shot feel like hell!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-05-04Moderna
22021-06-01Moderna

Free text

Release 8 — day 0, dose 1

2021-05-04

Systemic reaction (other): Shortness of breath- Asthmatic on nebulizer

Release 8 — days 1–6 daily, dose 1

2021-05-05

Systemic reaction (other): During the night I had an event that made me feel like a high fever and delirium and/or onset of bad asthma attack. Event like none other. Shortness of breath and panic

2021-05-07

Systemic reaction (other): First ever vaccine that I had side effects from

2021-05-08

Systemic reaction (other): Still unnecessarily anxious and short of breath

2021-05-09

Systemic reaction (other): I believe I may be a long hauler undiagnosed as I have been deathly ill with Covid symptoms all year

2021-05-10

Systemic reaction (other): Shortness of breath continual- eyesight still momentary double-vision and headaches pretty unbearable

Release 8 — day 7, dose 1

2021-05-11

Systemic reaction (other): Still have extreme shortness of breath

Release 8 — day 0, dose 2

2021-06-01

Systemic reaction (other): 12 hours after shot feel like hell!

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
SROAdverse reaction ✓ ✓ ✓
SROAnxiety ✓ ✓ ✓
SROAsthma ✓ ✓ ✓
SRODelirium ✓ ✓ ✓
SRODiplopia ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROGeneral symptom ✓ ✓ ○
SROHeadache ✓ ✓ ✓
SROMalaise · · ✓
SROPre-existing disease ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓

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