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S4H-61556-19460

1 vaccination 3 coded responses 8 check-ins 3 free-text entries 3 call cases
Sex
—
Age at first dose
41-45
ZIP prefix
762 / TX
Registered
2021-01-03
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-03
    Registered in v-safe
  2. 2021-01-03
    Dose 1 — Moderna
  3. 2021-01-03
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Seizure, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Free text: Severe convulsions last night, to the point that food i ate stuck in my throat for a half hour because i was shaking and shivering so bad.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-04
  6. 2021-01-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-01-05
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  8. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · None
    Adult check-in
  9. 2021-01-10
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-17
    Survey response — day 14, dose 1
    MedDRA: Anosmia — Feeling: Good
    Free text: Complete loss of smell for 2 days, its partially returned today. I suspect i had covid without symptoms when i received the vaccine. Feel great today though. Was not tested.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-07-04
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  12. 2022-01-03
    Survey response — 12 months, dose 1
    MedDRA: COVID-19 — Feeling: Good · 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
    Free text: Covid
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-01-03
    Report sent to call center — 12 months, 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 · 1 call case(s)
  14. 2022-01-04
  15. 2022-01-07

Vaccinations

DoseDateManufacturerCo-administered
12021-01-03Moderna

Call center

3 call center cases

1 unsuccessful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-04

Systemic reaction (other): Severe convulsions last night, to the point that food i ate stuck in my throat for a half hour because i was shaking and shivering so bad.

Release 2 — day 14, dose 1

2021-01-17

Symptoms: Complete loss of smell for 2 days, its partially returned today. I suspect i had covid without symptoms when i received the vaccine. Feel great today though. Was not tested.

Release 10 — 12 months, dose 1

2022-01-03

Symptoms: Covid

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
SDAnosmia ✓ ✓ ✓
SDCOVID-19 · · ✓
SROChills ✓ ✓ ✓
SROSeizure ✓ ✓ ✓
SROTremor ✓ ✓ ✓

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