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6RA-29281-09217

1 vaccination 5 coded responses 15 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
31-35
ZIP prefix
926 / CA
Registered
2021-11-05
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-11-05
    Registered in v-safe
  2. 2021-11-05
    Dose 1 — Moderna
  3. 2021-11-05
    Survey response — day 0, dose 1
    MedDRA: Dizziness — Feeling: Good · Site: Pain
    Free text: Feeling faint right after for like 15 minutes
    MedDRA releases: 2024-11 · check-in free text available
  4. 2021-11-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-11-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-11-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-11-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-11-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Anxiety — Feeling: Good
    Free text: I've anxiety for like 2 weeks but I don't think it's vaccine related
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-11-12
    Survey response — day 7, dose 1
    MedDRA: Sensory disturbance — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Can't tell if my heart has been feeling weird the past week or if it's something else.
    MedDRA releases: 2024-11 · check-in free text available
  10. 2021-11-19
    Survey response — day 14, dose 1
    MedDRA: Anxiety, Emergency care, Panic attack — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: A lot of Anxiety . Panic attack on weds. Went to ER today
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-11-26
    Survey response — day 21, dose 1
    MedDRA: Anxiety, Emergency care, Inflammation, Office visit, Palpitations — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit
    Free text: Symptoms: For the past few weeks after the vaccine I've had unexplained anxiety and heart palpitations . I've had to call 911, go to urgent care, go to the ER, see a cardiologist, get an echo cardiogram done, monitor my heart rate for 5 days. He said inflammat · Healthcare visit (other): Cardiologist and primary care provider too
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-11-26
    Report sent to call center — day 21, dose 1
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
  13. 2021-11-30
  14. 2021-12-03
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  15. 2021-12-10
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  16. 2021-12-17
    Health check-in — day 42, dose 1
    Feeling: Good
    Adult check-in
  17. 2022-02-04
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  18. 2022-05-06
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  19. 2022-11-05
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-11-05Moderna No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 10 — day 0, dose 1

2021-11-05

Systemic reaction (other): Feeling faint right after for like 15 minutes

Release 10 — days 1–6 daily, dose 1

2021-11-11

Systemic reaction (other): I've anxiety for like 2 weeks but I don't think it's vaccine related

Release 10 — day 7, dose 1

2021-11-12

Systemic reaction (other): Can't tell if my heart has been feeling weird the past week or if it's something else.

Release 10 — day 14, dose 1

2021-11-19

Symptoms: A lot of Anxiety . Panic attack on weds. Went to ER today

Release 10 — day 21, dose 1

2021-11-26

Symptoms: For the past few weeks after the vaccine I've had unexplained anxiety and heart palpitations . I've had to call 911, go to urgent care, go to the ER, see a cardiologist, get an echo cardiogram done, monitor my heart rate for 5 days. He said inflammat cut off by CDC
Healthcare visit (other): Cardiologist and primary care provider too

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
HCVOOffice visit · · ✓
SDAnxiety · · ✓
SDEmergency care · · ✓
SDInflammation · · ✓
SDOffice visit · · ✓
SDPalpitations · · ✓
SDPanic attack · · ✓
SROAnxiety · · ✓
SRODizziness · · ✓
SROSensory disturbance · · ✓

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

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