2H3-10239-84574
1 vaccination
4 coded responses
12 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 320 / FL
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-08
Dose 1 — Moderna
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2021-01-12
Registered in v-safe
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2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Chills, Drainage, Heart rate increased, Injection site bruising, Injection site haemorrhage, Oropharyngeal pain, Pain, Pain in extremity, Throat irritation — Feeling: Fair · Site: Pain, RednessFree text: The injection site is bruised more than red. I did bleed when I got the injection. This is the first I've registered so didn't get to report my symptoms from the first few days. First day I had elevated pulse for two hours along with chest tightness and also throat drainage. Sore arm. Second day chills and achey and sore throat from drainage. Still have drainage and irritated throat today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Paranasal sinus hypersecretion, Respiratory symptom — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Chest tightness, sinus drainage, asthma symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-14
- 2021-01-15
- 2021-01-22
- 2021-01-29
- 2021-02-05
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2021-02-12
Survey response — day 35, dose 1MedDRA: Asthma, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Still having asthma exacerbation since first vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Report sent to call center — day 35, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-19
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2021-03-08
Call successfulParticipant prefers to complete VAERS report online
- 2021-04-11
- 2021-07-09
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2022-01-08
Survey response — 12 months, dose 1MedDRA: Dermatitis contact — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Contact dermatitis on back and scalpMedDRA releases: 2024-11 · check-in free text available
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2022-01-08
Report sent to call center — 12 months, dose 1Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-01-10
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): The injection site is bruised more than red. I did bleed when I got the injection. This is the first I've registered so didn't get to report my symptoms from the first few days. First day I had elevated pulse for two hours along with chest tightness and also throat drainage. Sore arm. Second day chills and achey and sore throat from drainage. Still have drainage and irritated throat today.
Systemic reaction (other): Chest tightness, sinus drainage, asthma symptoms
Release 4 — day 35, dose 1
Symptoms: Still having asthma exacerbation since first vaccine
Release 10 — 12 months, dose 1
Symptoms: Contact dermatitis on back and scalp
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 |
|---|---|---|---|---|
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Asthma prophylaxis | ○ | ○ | ○ |
| SD | Dermatitis contact | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Drainage | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site haemorrhage | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SRO | Respiratory symptom | ✓ | ✓ | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release