5LA-18102-86989
4 vaccinations
6 coded responses
32 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 043 / ME
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
-
2021-03-04
Survey response — day 0, dose 1MedDRA: Allergy to chemicals, Dysgeusia, Hypersensitivity, Immediate post-injection reaction, Pre-existing disease, Product after taste — Feeling: Good · Site: PainFree text: Could taste vaccine right after injection. I have chemical sensitivity.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Had trouble sleeping last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-10
- 2021-03-11
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
-
2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Hangover — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Fatigue or tiredness, Abdominal pain · Be unable to workFree text: Felt hungoverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Nausea — Feeling: Good · Site: Pain, SwellingFree text: I missed yesterdays check in to clarify my severe chills started 10 hours after injection which was actually Day 1 after I had already reported. Yesterday I felt somewhat nauseous but otherwise okMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Insomnia — Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessFree text: Could not sleep last night. Similar to first night after 1st shot but this was night 4.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-17
- 2021-04-24
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-04
- 2021-10-02
-
2021-11-17
Dose 3 — Moderna
- 2022-04-03
-
2022-04-20
Dose 4 — Pfizer-BioNTech
-
2022-04-30
Survey response — day 7, dose 4MedDRA: Chills, Hypersomnia, Reaction to previous exposure to any vaccine — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Had severe chills and needed to sleep hours 9-22 following receiving dose 4 w Pfizer, similar to Moderna reactionMedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-01
- 2022-07-22
- 2022-10-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
| 4 | 2022-04-20 | Pfizer-BioNTech | No |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Could taste vaccine right after injection. I have chemical sensitivity.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Had trouble sleeping last night
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Felt hungover
Systemic reaction (other): I missed yesterdays check in to clarify my severe chills started 10 hours after injection which was actually Day 1 after I had already reported. Yesterday I felt somewhat nauseous but otherwise ok
Systemic reaction (other): Could not sleep last night. Similar to first night after 1st shot but this was night 4.
Release 11 — day 7, dose 4
Systemic reaction (other): Had severe chills and needed to sleep hours 9-22 following receiving dose 4 w Pfizer, similar to Moderna reaction
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 | Allergy to chemicals | ○ | ✓ | ○ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ○ | ✓ | ○ |
| SRO | Hangover | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | · | ✓ |
| SRO | Hypersomnia | · | · | ✓ |
| SRO | Immediate post-injection reaction | ✓ | · | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
| SRO | Product after taste | ✓ | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release