2PU-29671-86259

5 vaccinations 16 coded responses 36 check-ins 16 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 908 / CA
Registered: 2021-02-24

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-20
Dose 1 — Moderna
2021-02-17
Dose 2 — Moderna
2021-02-24
Registered in v-safe
2021-02-24
Survey response — day 7, dose 2
MedDRA: Chapped lips, Dry mouth, Lip exfoliation, Stomatitis, Tongue blistering — Feeling: Poor · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: sores on tongue and mouth; severe dryness of mouth; cracking and peeling of lips

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 14, dose 2
MedDRA: Cold sweat, Dry mouth, Stomatitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sores in mouth keep reoccurring and dry mouth does not improve. Also, cold sweats have returned

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 21, dose 2
MedDRA: Dry mouth, Office visit, Stomatitis — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My tongue and mouth still have sores and extreme dryness if I did not have the prescription to increase my saliva production I would not be able to even speak · Healthcare visit (other): In office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-03-19
Survey response — day 28, dose 2
MedDRA: Dry mouth, Glossodynia, Office visit, Stomatitis — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: The mouth and tongue sores keep reappearing. Dry mouth is sometimes worse than other times · Healthcare visit (other): In person

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Heart rate increased — Feeling: Fair

Free text: Rapid heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-09-30
Call 1 — Left Voicemail
2021-11-11
Dose 3 — Moderna
2021-11-11
Survey response — day 0, dose 3
MedDRA: Stomatitis — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Sores on tongue and mouth

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Survey response — days 1–6 daily, dose 3
MedDRA: Stomatitis, Tongue ulceration — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Mouth and tongue sores

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — days 1–6 daily, dose 3
MedDRA: Stomatitis, Tongue ulceration — Feeling: Good · Site: Pain

Free text: Mouth and tongue sores

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Stomatitis, Tongue ulceration — Feeling: Good · Site: Pain

Free text: Tongue and mouth sores

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Stomatitis, Tongue ulceration — Feeling: Good · Site: Pain

Free text: Mouth and tongue sores. These have been consistent since after the first vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Stomatitis, Tongue ulceration — Feeling: Good

Free text: Sores on tongue and mouth

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 7, dose 3
MedDRA: Office visit, Stomatitis, Tongue ulceration — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sores on tongue and mouth · Healthcare visit (other): My ent

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-19
Call 1 — Left Voicemail
2021-11-22
Call 2 — Left Voicemail
2021-11-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-17
Survey response — day 35, dose 3
MedDRA: Stomatitis, Tongue ulceration — Feeling: Fair

Free text: Mouth sores returned and tongue sores

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Survey response — day 42, dose 3
MedDRA: Adverse reaction, Office visit, Oral discomfort, Stomatitis, Tongue discomfort, Tongue ulceration — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: In addition to the tongue and mouth sores my mouth and tongue feel like their burning · Healthcare visit (other): I have been to 3 types of drs and no one can figure out what to do for me

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-29
Call 1 — Left Voicemail
2021-12-30
Call successful
Participant prefers to complete VAERS report online
2022-02-12
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-19
Dose 4 — Moderna
2022-05-26
Survey response — day 7, dose 4
MedDRA: Tongue ulceration — Feeling: Good · Site: Pain

Free text: Sores on tongue reappeared

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-09
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-18
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-05
Dose 5 — Moderna
2022-09-22
Survey response — day 14, dose 5
MedDRA: Abdominal pain upper, Headache, Myalgia — Feeling: Fair

Free text: Muscle aches, headache, stomach pains

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-03
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-17
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-05
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-03-06
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-11-11	Moderna	No
4	2022-05-19	Moderna	No
5	2022-09-05	Moderna	No

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): sores on tongue and mouth; severe dryness of mouth; cracking and peeling of lips

Release 4 — day 14, dose 2

2021-03-03

Symptoms: Sores in mouth keep reoccurring and dry mouth does not improve. Also, cold sweats have returned

Release 5 — day 21, dose 2

2021-03-10

Symptoms: My tongue and mouth still have sores and extreme dryness if I did not have the prescription to increase my saliva production I would not be able to even speak

Healthcare visit (other): In office visit

Release 5 — day 28, dose 2

2021-03-19

Symptoms: The mouth and tongue sores keep reappearing. Dry mouth is sometimes worse than other times

Healthcare visit (other): In person

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Rapid heart rate

Release 10 — day 0, dose 3

2021-11-11

Systemic reaction (other): Sores on tongue and mouth

Release 10 — days 1–6 daily, dose 3

2021-11-12

Systemic reaction (other): Mouth and tongue sores

2021-11-13

Systemic reaction (other): Mouth and tongue sores

2021-11-14

Systemic reaction (other): Tongue and mouth sores

2021-11-15

Systemic reaction (other): Mouth and tongue sores. These have been consistent since after the first vaccine

2021-11-16

Systemic reaction (other): Sores on tongue and mouth

Release 10 — day 7, dose 3

2021-11-18

Systemic reaction (other): Sores on tongue and mouth

Healthcare visit (other): My ent

Release 10 — day 35, dose 3

2021-12-17

Symptoms: Mouth sores returned and tongue sores

Release 10 — day 42, dose 3

2021-12-25

Symptoms: In addition to the tongue and mouth sores my mouth and tongue feel like their burning

Healthcare visit (other): I have been to 3 types of drs and no one can figure out what to do for me

Release 11 — day 7, dose 4

2022-05-26

Systemic reaction (other): Sores on tongue reappeared

Release 12 — day 14, dose 5

2022-09-22

Symptoms: Muscle aches, headache, stomach pains

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
HCVO	Adverse reaction	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal pain upper	·	·	✓
SD	Cold sweat	✓	✓	✓
SD	Dry mouth	✓	✓	✓
SD	Glossodynia	✓	✓	✓
SD	Headache	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Oral discomfort	·	·	✓
SD	Stomatitis	✓	✓	✓
SD	Tongue discomfort	·	·	✓
SD	Tongue ulceration	·	·	✓
SRO	Chapped lips	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Lip exfoliation	✓	✓	✓
SRO	Stomatitis	✓	✓	✓
SRO	Tongue blistering	✓	✓	✓
SRO	Tongue ulceration	·	·	✓

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