4KH-13497-75267
3 vaccinations
3 coded responses
3 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 910 / CA
- Registered
- 2021-04-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Dose 1 — Moderna
-
2021-03-30
Dose 2 — Moderna
-
2021-04-27
Registered in v-safe
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2021-04-28
Survey response — day 28, dose 2MedDRA: Urticaria — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Hives for over 2 weeks, no previous allergies or hives reactions.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-28
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-29
Survey response — 3 months, dose 2MedDRA: Unevaluable event, Urticaria — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Ongoing problems managing hives which started two weeks after my second dose of Moderna. I had another hives break out a week ago. I am back on prednisone to address this. Ive never had hives before this. · Healthcare visit (other): Now receiving Xolair shotsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-29
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-07
Call successfulParticipant prefers to complete VAERS report online
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2022-04-12
Dose 3 — Moderna
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2022-07-12
Survey response — 3 months, dose 3MedDRA: Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: My chronic hives have returned since my April booster vaccine. I have begun taking Xolair shots again. My hives had been under control for the six month prior to the booster. · Healthcare visit (other): Xolair shotMedDRA releases: 2024-11 · check-in free text available
-
2022-07-12
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
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2022-07-13
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2022-04-12 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 8 — day 28, dose 2
Symptoms: Hives for over 2 weeks, no previous allergies or hives reactions.
Release 9 — 3 months, dose 2
Symptoms: Ongoing problems managing hives which started two weeks after my second dose of Moderna. I had another hives break out a week ago. I am back on prednisone to address this. Ive never had hives before this.
Healthcare visit (other): Now receiving Xolair shots
Release 12 — 3 months, dose 3
Symptoms: My chronic hives have returned since my April booster vaccine. I have begun taking Xolair shots again. My hives had been under control for the six month prior to the booster.
Healthcare visit (other): Xolair shot
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release