Z3M-10920-35931
2 vaccinations
1 coded response
25 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 26-30
- ZIP prefix
- 226 / VA
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Registered in v-safe
-
2021-01-27
Dose 1 — Moderna
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-02-25
Dose 2 — Moderna
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fall, Headache, Loss of consciousness — Feeling: Good · Site: Swelling · HeadacheFree text: I have had headaches off and on since the evening of 02/25, the day I got the vaccine. I woke up during the early morning of 02/26 and experienced some chills. I passed out getting out of the shower that morning. That was the last severe symptom I've experienced, and my headaches since then might be explained just by that. I sat down after getting out of the shower because I was already going, and ended up falling over. I probably hit my head on the side of the tub, but I can't be sure.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-06
- 2021-03-11
- 2021-03-18
- 2021-03-27
- 2021-04-01
- 2021-04-10
- 2021-05-27
- 2021-08-26
- 2022-02-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-25 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I have had headaches off and on since the evening of 02/25, the day I got the vaccine. I woke up during the early morning of 02/26 and experienced some chills. I passed out getting out of the shower that morning. That was the last severe symptom I've experienced, and my headaches since then might be explained just by that. I sat down after getting out of the shower because I was already going, and ended up falling over. I probably hit my head on the side of the tub, but I can't be sure.
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 | Chills | ✓ | ✓ | ✓ |
| SRO | Fall | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Loss of consciousness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release