64W-27483-00758
2 vaccinations
5 coded responses
13 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 481 / MI
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Dose 1 — Moderna
-
2021-03-19
Registered in v-safe
- 2021-03-19
-
2021-03-20
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Fibromyalgia, Pre-existing disease — Feeling: Good · Site: PainFree text: My fibromyalgia is acting up.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-25
- 2021-04-10
-
2021-04-14
Dose 2 — Moderna
- 2021-04-23
- 2021-04-28
-
2021-05-07
Survey response — day 21, dose 2MedDRA: Abdominal pain upper, Blood pressure increased, Depression, Feeling hot, Gastrooesophageal reflux disease, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Blood pressure rising, headaches, face hot, depression bad. Stomach cramps & acid reflux acting up. Going on the past week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
-
2021-05-19
Survey response — day 35, dose 2MedDRA: Blood pressure decreased, Blood pressure increased — Feeling: Fair · Be unable to do your normal daily activitiesFree text: My blood pressure has been increasing since I received my vaccines. Historically my BP has always been low. On the 17th it was 190/81, 18th morning 190/105, before noon 182/102, 19th 167/101. If it continues tomorrow I will notify my dr.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-28
Survey response — day 42, dose 2MedDRA: Headache, Hypertension — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headaches, high blood pressureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-13
-
2022-04-17
Survey response — 12 months, dose 2MedDRA: Gastric haemorrhage, Hospitalisation — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Stomach bleeding. Hospitalized for a week.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-14 | Moderna |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): My fibromyalgia is acting up.
Release 8 — day 21, dose 2
Symptoms: Blood pressure rising, headaches, face hot, depression bad. Stomach cramps & acid reflux acting up. Going on the past week.
Release 8 — day 35, dose 2
Symptoms: My blood pressure has been increasing since I received my vaccines. Historically my BP has always been low. On the 17th it was 190/81, 18th morning 190/105, before noon 182/102, 19th 167/101. If it continues tomorrow I will notify my dr.
Release 8 — day 42, dose 2
Symptoms: Headaches, high blood pressure
Release 11 — 12 months, dose 2
Symptoms: Stomach bleeding. Hospitalized for a week.
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Blood pressure decreased | ✓ | ✓ | ✓ |
| SD | Blood pressure increased | ✓ | ✓ | ✓ |
| SD | Depression | ✓ | ✓ | ✓ |
| SD | Feeling hot | ✓ | ✓ | ✓ |
| SD | Gastric haemorrhage | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Hypertension | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Fibromyalgia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release