5RU-30211-54348
1 vaccination
2 coded responses
2 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 030 / NH
- Registered
- 2021-04-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-21
Dose 1 — Moderna
-
2021-04-26
Registered in v-safe
-
2021-04-26
Survey response — days 1–6 daily, dose 1MedDRA: Emergency care, Pain — Feeling: Poor · Site: Pain · Chills, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): One day after vaccine I experienced all of these symptoms I mentioned and felt us though I was going to pass out, fell to the floor, body became numb, fingers were hardening up I all different directions, thrashing about in floor because I was having trouble breathing, skin was a Pakistani yellow. Husband called 911 . Paramedics tended to me at my home. Have not been quite the same since then. · Healthcare visit (other): Paramedics were called to my house through a 911 call from husbandMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-28
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: FairFree text: I had a pretty bad reaction within 24 hours of getting shot, so Im surprised theres been no follow up through this site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2022-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-21 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 8 — days 1–6 daily, dose 1
Systemic reaction (other): One day after vaccine I experienced all of these symptoms I mentioned and felt us though I was going to pass out, fell to the floor, body became numb, fingers were hardening up I all different directions, thrashing about in floor because I was having trouble breathing, skin was a Pakistani yellow. Husband called 911 . Paramedics tended to me at my home. Have not been quite the same since then.
Healthcare visit (other): Paramedics were called to my house through a 911 call from husband
Release 8 — day 7, dose 1
Systemic reaction (other): I had a pretty bad reaction within 24 hours of getting shot, so Im surprised theres been no follow up through this site.
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 |
|---|---|---|---|---|
| HCVO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release