ZWZ-13113-65155
1 vaccination
1 coded response
2 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 627 / IL
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Moderna
-
2021-03-08
Registered in v-safe
-
2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea, Feeling jittery, Headache, Hot flush, Insomnia, Pyrexia — Feeling: Good · Headache, Abdominal painFree text: had very bad reactions day of my shot and that nigh t and next day.Rapid heart beat 3 different times about 3hrs after shot. That evening and night had labored breathing to the point i almost went to hospital. Was very gittery all night and could not go to sleep.Got maybe 2hrs sleep.Next day had headache off and on.Had a few hot flashes Thursday and a fever later that night...finnally started feeling better late Friday March 5thMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): had very bad reactions day of my shot and that nigh t and next day.Rapid heart beat 3 different times about 3hrs after shot. That evening and night had labored breathing to the point i almost went to hospital. Was very gittery all night and could not go to sleep.Got maybe 2hrs sleep.Next day had headache off and on.Had a few hot flashes Thursday and a fever later that night...finnally started feeling better late Friday March 5th
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 | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Feeling jittery | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release