6SM-17845-78011
2 vaccinations
4 coded responses
26 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 480 / MI
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
-
2021-02-03
Survey response — day 0, dose 1MedDRA: Blood pressure increased, Dizziness, Eye pain, Head discomfort, Hyperhidrosis, Immediate post-injection reaction, Medical observation, Motion sickness, Ocular discomfort, Paraesthesia, Peripheral coldness — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Blood pressure spike within 10 minutes of vaccine 158 over 70. Normal range is 90 over 68. Feeling like having allergic reaction, prickly skin on arms and back of neck. Also sensation like having very bad motion sickness. Very light headed. Pain behind and in eye socket. Waves of pressure paim across forehead and eyes. Very cold hands, but sweaty hands. · Healthcare visit (other): Could not leave vaccination clinic for hour after shot. Had blood pressure monitored and dizziness monitored.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-03
Report sent to call center — day 0, 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)
-
2021-02-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Constipation — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Constipation — Feeling: GoodFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
-
2021-02-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Fatigue or tiredness, DiarrheaAdult check-in
-
2021-02-09
Health check-in — days 1–6 daily, dose 1Feeling: Good · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
-
2021-03-03
Survey response — day 0, dose 2MedDRA: Cold sweat, Hypertension, Medical observation, Motion sickness, Peripheral coldness, Vertigo — Feeling: Fair · Headache, Nausea · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): High blood pressure, cold clammy hands, vertigo, motion sicknrss · Healthcare visit (other): At site through health departmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Report sent to call center — day 0, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-06-02
-
2021-06-22
Call successfulDoes not wish to fill out VAERS report
- 2021-09-01
- 2022-03-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Blood pressure spike within 10 minutes of vaccine 158 over 70. Normal range is 90 over 68. Feeling like having allergic reaction, prickly skin on arms and back of neck. Also sensation like having very bad motion sickness. Very light headed. Pain behind and in eye socket. Waves of pressure paim across forehead and eyes. Very cold hands, but sweaty hands.
Healthcare visit (other): Could not leave vaccination clinic for hour after shot. Had blood pressure monitored and dizziness monitored.
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Constipation
Systemic reaction (other): Constipation
Release 5 — day 0, dose 2
Systemic reaction (other): High blood pressure, cold clammy hands, vertigo, motion sicknrss
Healthcare visit (other): At site through health department
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 | Blood pressure increased | ✓ | ✓ | ✓ |
| HCVO | Dizziness | ✓ | ✓ | ✓ |
| HCVO | Medical observation | ✓ | ✓ | ✓ |
| SRO | Blood pressure increased | ✓ | ✓ | ✓ |
| SRO | Cold sweat | ✓ | ✓ | ✓ |
| SRO | Constipation | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Head discomfort | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Hypertension | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Motion sickness | ✓ | ✓ | ✓ |
| SRO | Ocular discomfort | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Peripheral coldness | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release