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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

  1. 2021-02-13
    Registered in v-safe
  2. 2021-02-13
    Dose 1 — Moderna
  3. 2021-02-13
    Health check-in — day 0, dose 1
    Feeling: Fair · Site: Pain, Swelling · Chills
    Adult check-in
  4. 2021-02-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches
    Adult check-in
  5. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Chills, Headache
    Adult check-in
  6. 2021-02-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Chills, Headache
    Adult check-in
  7. 2021-02-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Chills
    Adult check-in
  8. 2021-02-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Chills
    Adult check-in
  9. 2021-02-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Chills
    Adult check-in
  10. 2021-02-20
    Survey response — day 7, dose 1
    MedDRA: Chills, Pre-existing disease — Feeling: Fair · Site: Pain · Chills
    Free 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
  11. 2021-02-28
    Survey response — day 14, dose 1
    MedDRA: Headache, Nausea — Feeling: Fair
    Free 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
  12. 2021-03-13
    Survey response — day 28, dose 1
    MedDRA: Chills, Nausea — Feeling: Fair
    Free text: Nauseous & chill in both arms on & off every day.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-18
    Survey response — 3 months, dose 1
    MedDRA: Chills, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to do your normal daily activities
    Free 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

DoseDateManufacturerCo-administered
12021-02-13Moderna

Free text

Release 4 — day 7, dose 1

2021-02-20

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

2021-02-28

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

2021-03-13

Symptoms: Nauseous & chill in both arms on & off every day.

Release 8 — 3 months, dose 1

2021-05-18

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

FieldPreferred term2021-092023-042024-11
SDChills ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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