5UB-33398-86514
1 vaccination
4 coded responses
11 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 112 / NY
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body achesAdult check-in
-
2021-02-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Chills, HeadacheAdult check-in
-
2021-02-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, HeadacheAdult check-in
-
2021-02-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · ChillsAdult check-in
- 2021-02-18
- 2021-02-19
-
2021-02-20
Survey response — day 7, dose 1MedDRA: Chills, Pre-existing disease — Feeling: Fair · Site: Pain · ChillsFree text: The chill comes on and off everyday and when Im eating dinner. I had MRI with contrast Gadolinium 3 days before they COVID-19 vaccine. I do have arrhythmia for a few years.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-28
Survey response — day 14, dose 1MedDRA: Headache, Nausea — Feeling: FairFree text: Headache in area behind my left ear and above left side of neck. These pains are on & off every day. Nausea every day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — day 28, dose 1MedDRA: Chills, Nausea — Feeling: FairFree text: Nauseous & chill in both arms on & off every day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-18
Survey response — 3 months, dose 1MedDRA: Chills, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I still have my both arms goosebump chill hot back since 1st. vaccine sneeze & running nose over 3 weeks I dont have allergies before Please tell me how to get rid these problems Should I go for another COVID test?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna |
Free text
Release 4 — day 7, dose 1
Systemic reaction (other): The chill comes on and off everyday and when Im eating dinner. I had MRI with contrast Gadolinium 3 days before they COVID-19 vaccine. I do have arrhythmia for a few years.
Release 4 — day 14, dose 1
Symptoms: Headache in area behind my left ear and above left side of neck. These pains are on & off every day. Nausea every day.
Release 5 — day 28, dose 1
Symptoms: Nauseous & chill in both arms on & off every day.
Release 8 — 3 months, dose 1
Symptoms: I still have my both arms goosebump chill hot back since 1st. vaccine sneeze & running nose over 3 weeks I dont have allergies before Please tell me how to get rid these problems Should I go for another COVID test?
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 | Chills | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release