YLD-25207-19178
2 vaccinations
2 coded responses
23 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 305 / GA
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-18
Registered in v-safe
-
2021-02-18
Dose 1 — Moderna
- 2021-02-18
-
2021-02-19
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Disorientation, Fall, Limb discomfort — Feeling: Fair · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activitiesFree text: At 8am I was disoriented and fell down twice and had chills after. I lost control of my legs. This went on for 15 minutesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
-
2021-02-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-02-23
- 2021-02-24
- 2021-02-27
- 2021-03-04
- 2021-03-11
-
2021-03-17
Dose 2 — Moderna
-
2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Balance disorder, Fall, Tremor, Vaccine positive rechallenge — Feeling: Fair · Site: Pain · Be unable to work, Be unable to do your normal daily activitiesFree text: At 10am today I started shaking really bad and lost all balance and fell straight down. I could not hold myself from falling. My wife tried to help me get up but I fell again and continued shaking. It went away after 10 minutes. Same thing happened on the day after I received my first shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-06-19
- 2021-09-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-18 | Moderna | |
| 2 | 2021-03-17 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): At 8am I was disoriented and fell down twice and had chills after. I lost control of my legs. This went on for 15 minutes
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): At 10am today I started shaking really bad and lost all balance and fell straight down. I could not hold myself from falling. My wife tried to help me get up but I fell again and continued shaking. It went away after 10 minutes. Same thing happened on the day after I received my first shot.
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 |
|---|---|---|---|---|
| SRO | Balance disorder | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Disorientation | ✓ | ✓ | ✓ |
| SRO | Fall | ✓ | ✓ | ✓ |
| SRO | Limb discomfort | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release