4U3-93672-31239
4 vaccinations
6 coded responses
16 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 088 / NJ
- Registered
- 2021-12-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-05
Dose 1 — Moderna
-
2021-06-02
Dose 2 — Moderna
-
2021-10-20
Dose 3 — Moderna
-
2021-12-14
Registered in v-safe
- 2022-01-19
- 2022-04-23
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2022-05-27
Dose 4 — Moderna
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2022-05-27
Survey response — day 0, dose 4MedDRA: Periorbital swelling — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Huge bags under my eyes appeared approximately 2.5 hours after injectionMedDRA releases: 2024-11 · check-in free text available
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2022-05-28
Survey response — days 1–6 daily, dose 4MedDRA: Pain in extremity, Vaccine positive rechallenge — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: As with previous doses, unbearable leg painMedDRA releases: 2024-11 · check-in free text available
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2022-05-29
Survey response — days 1–6 daily, dose 4MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Legs still feel sore/ache but not nearly as bad as 12-20 hours after injection.MedDRA releases: 2024-11 · check-in free text available
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2022-05-30
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-31
- 2022-06-01
- 2022-06-02
- 2022-06-03
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2022-06-10
Survey response — day 14, dose 4MedDRA: Pre-existing disease, Psoriasis, Vaccine positive rechallenge — Feeling: GoodFree text: Psoriasis is getting out of control again. This has been the case/timeframe with each dose. In between 1st 3 doses, topical med diflorasone diacetate was completely ineffective although it was the only med that ever got me to remission.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-19
- 2022-06-24
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2022-07-01
Survey response — day 35, dose 4MedDRA: Nodule, Onychomycosis, Pre-existing disease, Psoriasis, Psoriatic arthropathy — Feeling: FairFree text: Psoriatic arthritis flare up in a finger worse than ever before; fungus in nail and what looks like a bone growing out of finger just below nail. Psoriasis out of control!MedDRA releases: 2024-11 · check-in free text available
- 2022-07-08
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2022-08-26
Survey response — 3 months, dose 4MedDRA: Diarrhoea, Hypertension, Office visit, Pain, Sinusitis, Tooth infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Sinus infection. Tooth infection. High blood pressure. Horrible, painful diarrhea probably from antibiotics. · Healthcare visit (other): DentistMedDRA releases: 2024-11 · check-in free text available
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2022-08-26
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-08-29
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-05 | Moderna | No |
| 2 | 2021-06-02 | Moderna | No |
| 3 | 2021-10-20 | Moderna | No |
| 4 | 2022-05-27 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 11 — day 0, dose 4
Systemic reaction (other): Huge bags under my eyes appeared approximately 2.5 hours after injection
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): As with previous doses, unbearable leg pain
Systemic reaction (other): Legs still feel sore/ache but not nearly as bad as 12-20 hours after injection.
Release 12 — day 14, dose 4
Symptoms: Psoriasis is getting out of control again. This has been the case/timeframe with each dose. In between 1st 3 doses, topical med diflorasone diacetate was completely ineffective although it was the only med that ever got me to remission.
Release 12 — day 35, dose 4
Symptoms: Psoriatic arthritis flare up in a finger worse than ever before; fungus in nail and what looks like a bone growing out of finger just below nail. Psoriasis out of control!
Release 12 — 3 months, dose 4
Symptoms: Sinus infection. Tooth infection. High blood pressure. Horrible, painful diarrhea probably from antibiotics.
Healthcare visit (other): Dentist
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 | Office visit | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Nodule | · | · | ✓ |
| SD | Onychomycosis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Psoriasis | · | · | ✓ |
| SD | Psoriatic arthropathy | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Tooth infection | · | · | ✓ |
| SD | Vaccine positive rechallenge | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Periorbital swelling | · | · | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release