4XT-10742-11852
3 vaccinations
6 coded responses
29 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 900 / CA
- Registered
- 2021-04-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-13
Dose 1 — Moderna
-
2021-04-14
Registered in v-safe
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2021-04-14
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain — Feeling: Good · Site: PainFree text: Feels like beginnings of a sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Headache, Odynophagia, Oropharyngeal pain — Feeling: Fair · Chills, HeadacheFree text: Sore throat was worse yesterday (noticed when swallowing), but is better today. Chills were temporary, headache is mild yet noticeable akin to not having any coffee in the morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-19
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2021-04-20
Survey response — day 7, dose 1MedDRA: Chills, Fatigue — Feeling: Good · Chills, Fatigue or tirednessFree text: Fatigue and chills were very mild and didnt last more than 15 mins. Took temp and it was 98.3MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-27
- 2021-05-04
-
2021-05-10
Dose 2 — Moderna
-
2021-05-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-12
- 2021-05-13
- 2021-05-14
- 2021-05-15
- 2021-05-16
- 2021-05-19
- 2021-05-24
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-06-21
- 2021-08-09
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2021-11-22
Dose 3 — ModernaCo-administered: Flu
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2021-11-23
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-11-25
- 2021-11-26
- 2021-11-28
- 2021-11-29
- 2021-12-06
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2021-12-13
Survey response — day 21, dose 3MedDRA: Back pain, Office visit, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: December 6th I developed hives that persist. Saw my PCP. Went to an allergist on the 10th who told me he's been seeing this in some patients post-booster. Recommended I start taking Allegra or Zyrtec. Some back pain has appeared as well. · Healthcare visit (other): Saw my primary doc, then later my wife booked an appointment with an allergist.MedDRA releases: 2024-11 · check-in free text available
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2021-12-13
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-14
-
2021-12-14
Call successfulParticipant prefers to complete VAERS report online
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2021-12-20
Survey response — day 28, dose 3MedDRA: Medical counselling, Self-medication, Urticaria — Feeling: FairFree text: Hives aren't worsening, but still persist. Taking Allegra daily on the recommendation of an allergist.MedDRA releases: 2024-11 · check-in free text available
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2021-12-27
Survey response — day 35, dose 3MedDRA: Pre-existing disease — Feeling: FairFree text: Not new or worsening but hives still persist.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Moderna | |
| 2 | 2021-05-10 | Moderna | |
| 3 | 2021-11-22 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Feels like beginnings of a sore throat
Systemic reaction (other): Sore throat was worse yesterday (noticed when swallowing), but is better today. Chills were temporary, headache is mild yet noticeable akin to not having any coffee in the morning.
Release 7 — day 7, dose 1
Systemic reaction (other): Fatigue and chills were very mild and didnt last more than 15 mins. Took temp and it was 98.3
Release 10 — day 21, dose 3
Symptoms: December 6th I developed hives that persist. Saw my PCP. Went to an allergist on the 10th who told me he's been seeing this in some patients post-booster. Recommended I start taking Allegra or Zyrtec. Some back pain has appeared as well.
Healthcare visit (other): Saw my primary doc, then later my wife booked an appointment with an allergist.
Release 10 — day 28, dose 3
Symptoms: Hives aren't worsening, but still persist. Taking Allegra daily on the recommendation of an allergist.
Release 10 — day 35, dose 3
Symptoms: Not new or worsening but hives still persist.
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 | Back pain | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Odynophagia | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release