43R-96856-63227
2 vaccinations
4 coded responses
12 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 21-25
- ZIP prefix
- 212 / MD
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-05
Dose 1 — Moderna
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2021-01-13
Registered in v-safe
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2021-01-13
Survey response — day 7, dose 1MedDRA: Lymphadenopathy, Medical counselling, Naevus haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): What I believe is my left supra clavicular lymph node is swollen and has been for the past few days. This is on the same side of the arm that I received the vaccine. Additionally, a mole on my left arm about 1-2 inches from the site of vaccination peeled off and started bleeding about 1 week after receiving the vaccine. Also as a note, this was all after the first dose of the vaccine. · Healthcare visit (other): I asked a medical doctor friend to look at the mole that was bleeding.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-20
Survey response — day 14, dose 1MedDRA: Lymphadenopathy, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: My Supra clavicular lymph nodes are more swollen than before and instead of just one it is two. They are both on the same side as the arm in which I received the vaccine. They do not hurt, they are just large and have not reduced in size. · Healthcare visit (other): Friend who is physicianMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-20
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-26
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2021-01-29
Dose 2 — Moderna
- 2021-02-02
- 2021-02-04
- 2021-02-05
- 2021-02-14
- 2021-02-19
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2021-02-26
Survey response — day 28, dose 2MedDRA: Fatigue, Sleep deficit — Feeling: FairFree text: Feeling more tired than lately. It could be because Im not getting enough sleep, but Ive been more tired in general.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Call successfulParticipant prefers to complete VAERS report online
- 2021-03-07
- 2021-03-13
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2021-04-30
Survey response — 3 months, dose 2MedDRA: Hordeolum, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Eye stye · Healthcare visit (other): Asked friend who is mid level providerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-30
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-01-29 | Moderna |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): What I believe is my left supra clavicular lymph node is swollen and has been for the past few days. This is on the same side of the arm that I received the vaccine. Additionally, a mole on my left arm about 1-2 inches from the site of vaccination peeled off and started bleeding about 1 week after receiving the vaccine. Also as a note, this was all after the first dose of the vaccine.
Healthcare visit (other): I asked a medical doctor friend to look at the mole that was bleeding.
Release 2 — day 14, dose 1
Symptoms: My Supra clavicular lymph nodes are more swollen than before and instead of just one it is two. They are both on the same side as the arm in which I received the vaccine. They do not hurt, they are just large and have not reduced in size.
Healthcare visit (other): Friend who is physician
Release 4 — day 28, dose 2
Symptoms: Feeling more tired than lately. It could be because Im not getting enough sleep, but Ive been more tired in general.
Release 8 — 3 months, dose 2
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Naevus haemorrhage | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hordeolum | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Sleep deficit | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Naevus haemorrhage | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release