6MT-81396-47337
2 vaccinations
3 coded responses
19 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 619 / IL
- Registered
- 2021-02-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-19
Dose 1 — Moderna
-
2021-02-22
Registered in v-safe
-
2021-02-22
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Emergency care, Fatigue, Headache, Hypotension, Loss of consciousness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Systemic reaction (other): My blood pressure crashed and I passed out. I was semi-concious for about 20 minutes. The gal that lives with me called for an ambulance. They stayed with me for about 30 minutes until my blood pressure came up a bit. I decided not to go to the ER which is about 40 minutes away. All of this happened yesterday, about 44 hours after the vavcine. I am better today. Just chillls, mild headache and fatigue. · Healthcare visit (other): Ambulence came to house but i did not go to the ERMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-22
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)
-
2021-02-23
Survey response — days 1–6 daily, dose 1MedDRA: Hyperhidrosis — Feeling: Good · Site: Pain · Fever · Chills, HeadacheFree text: SweatingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-25
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · NauseaFree text: Light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-03-05
- 2021-03-14
- 2021-03-21
-
2021-03-25
Dose 2 — Moderna
-
2021-03-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-29
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-23
- 2021-05-01
- 2021-05-08
- 2021-06-25
- 2021-09-25
- 2021-09-27
- 2022-03-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-19 | Moderna | |
| 2 | 2021-03-25 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): My blood pressure crashed and I passed out. I was semi-concious for about 20 minutes. The gal that lives with me called for an ambulance. They stayed with me for about 30 minutes until my blood pressure came up a bit. I decided not to go to the ER which is about 40 minutes away. All of this happened yesterday, about 44 hours after the vavcine. I am better today. Just chillls, mild headache and fatigue.
Healthcare visit (other): Ambulence came to house but i did not go to the ER
Systemic reaction (other): Sweating
Systemic reaction (other): Light headed
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 | Chills | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Hypotension | ✓ | ✓ | ✓ |
| SRO | Loss of consciousness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release