6X4-11703-19945
1 vaccination
4 coded responses
9 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 980 / WA
- Registered
- 2021-04-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-18
Registered in v-safe
-
2021-04-18
Dose 1 — Moderna
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2021-04-18
Survey response — day 0, dose 1MedDRA: Blood pressure systolic decreased, Dizziness, Feeling hot, Immediate post-injection reaction, Medical observation, Presyncope, Vomiting — Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I got really light headed right after the injection, felt way too hot (usually Im freezing), nearly passed out on the way to the observation room and threw up twice, the nurse said my blood pressure was 60 systolic. Im still in observation while writing this · Healthcare visit (other): Nurse had to take care of me and check in frequently between injection and observation (Im still in observation for a few more minutes)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-18
Report sent to call center — day 0, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-19
Survey response — days 1–6 daily, dose 1MedDRA: Renal pain — Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessFree text: My kidneys feel a little sore, kinda similar to menstrual pain (not nearly as intense) even though Im on birth control and dont menstruateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-21
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2021-04-22
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness, Diarrhea, Abdominal painFree text: Not sure if this is related to the shot or my celiacs diseaseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
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2021-04-24
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: Fair · Fatigue or tirednessFree text: My chest was super itchy last night, not sure why or if it had anything to do with the injection but it was certainly unusualMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-25
Health check-in — day 7, dose 1Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-03-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-18 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — day 0, dose 1
Systemic reaction (other): I got really light headed right after the injection, felt way too hot (usually Im freezing), nearly passed out on the way to the observation room and threw up twice, the nurse said my blood pressure was 60 systolic. Im still in observation while writing this
Healthcare visit (other): Nurse had to take care of me and check in frequently between injection and observation (Im still in observation for a few more minutes)
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): My kidneys feel a little sore, kinda similar to menstrual pain (not nearly as intense) even though Im on birth control and dont menstruate
Systemic reaction (other): Not sure if this is related to the shot or my celiacs disease
Systemic reaction (other): My chest was super itchy last night, not sure why or if it had anything to do with the injection but it was certainly unusual
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 | Medical observation | ✓ | ✓ | ✓ |
| SRO | Blood pressure systolic decreased | ○ | ✓ | ○ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Medical observation | ✓ | · | ✓ |
| SRO | Presyncope | ✓ | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Renal pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release