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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

  1. 2021-02-19
    Dose 1 — Moderna
  2. 2021-02-22
    Registered in v-safe
  3. 2021-02-22
    Survey response — days 1–6 daily, dose 1
    MedDRA: 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 visit
    Free 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 ER
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-22
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  5. 2021-02-23
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hyperhidrosis — Feeling: Good · Site: Pain · Fever · Chills, Headache
    Free text: Sweating
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-25
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dizziness — Feeling: Good · Nausea
    Free text: Light headed
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-26
    Health check-in — day 7, dose 1
    Feeling: Fair · Nausea, Abdominal pain
    Adult check-in
  8. 2021-03-05
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-03-14
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-21
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-25
    Dose 2 — Moderna
  12. 2021-03-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  13. 2021-03-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  14. 2021-03-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-04-01
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-04-08
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-15
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-23
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-05-01
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-08
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-06-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-09-25
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-09-27
  24. 2022-03-27
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-19Moderna
22021-03-25Moderna

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-22

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

2021-02-23

Systemic reaction (other): Sweating

2021-02-25

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

FieldPreferred term2021-092023-042024-11
HCVOEmergency care ✓ ✓ ✓
SROChills ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROHypotension ✓ ✓ ✓
SROLoss of consciousness ✓ ✓ ✓

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