5HF-33977-71667
2 vaccinations
10 coded responses
24 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 230 / VA
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-09
Registered in v-safe
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2021-03-09
Dose 1 — Moderna
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2021-03-09
Survey response — day 0, dose 1MedDRA: Eye irritation, Feeling abnormal — Feeling: GoodFree text: Eyes burning some, feel a little different.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
- 2021-03-11
- 2021-03-13
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Irritability — Feeling: Fair · HeadacheFree text: Slight headache everyday that i forgot to tell you about, feeling a little grouchy too.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Small rash with a lighter spot on my right cheek.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — day 7, dose 1MedDRA: Headache, Rash — Feeling: Fair · Headache, Rash, not including the immediate area around the injection siteFree text: Mild headache and rash on right cheek is noticeable but not itching.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-23
Survey response — day 14, dose 1MedDRA: Erythema, Feeling abnormal, Flushing, Headache — Feeling: FairFree text: Flushed, red face at times, still have mild headaches everyday which make me feel bad.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-30
Survey response — day 21, dose 1MedDRA: Nausea — Feeling: GoodFree text: Nauseated yesterday, a little clear liquid came up. Better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Dose 2 — Moderna
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2021-04-06
Survey response — day 0, dose 2MedDRA: Thermal burns of eye — Feeling: Good · Site: Pain · Fatigue or tiredness, NauseaFree text: Eyes burning like the last timeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · ChillsAdult check-in
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2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Eye irritation — Feeling: Good · Site: Redness, Swelling · Fatigue or tirednessFree text: Eyes still burning a little today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-22
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
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2021-07-06
Survey response — 3 months, dose 2MedDRA: Office visit, Oral pain, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Palsentile Tinnitus, went for ear exam. Roof of my mouth was sore for over a month. Pray these symptoms improve. · Healthcare visit (other): Ear clinicMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-06
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-09
Call successfulParticipant prefers to complete VAERS report online
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2021-10-05
Survey response — 6 months, dose 2MedDRA: Tongue erythema — Feeling: GoodFree text: Reddish spot on my tongue, it is a little better today. Had it for several weeks.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-06 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Eyes burning some, feel a little different.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Slight headache everyday that i forgot to tell you about, feeling a little grouchy too.
Systemic reaction (other): Small rash with a lighter spot on my right cheek.
Release 5 — day 7, dose 1
Systemic reaction (other): Mild headache and rash on right cheek is noticeable but not itching.
Release 6 — day 14, dose 1
Symptoms: Flushed, red face at times, still have mild headaches everyday which make me feel bad.
Release 6 — day 21, dose 1
Symptoms: Nauseated yesterday, a little clear liquid came up. Better today.
Release 7 — day 0, dose 2
Systemic reaction (other): Eyes burning like the last time
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Eyes still burning a little today.
Release 9 — 3 months, dose 2
Symptoms: Palsentile Tinnitus, went for ear exam. Roof of my mouth was sore for over a month. Pray these symptoms improve.
Healthcare visit (other): Ear clinic
Release 10 — 6 months, dose 2
Symptoms: Reddish spot on my tongue, it is a little better today. Had it for several weeks.
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 | Erythema | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Flushing | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Oral pain | ✓ | ✓ | ✓ |
| SD | Tinnitus | ✓ | ✓ | ✓ |
| SD | Tongue erythema | · | · | ✓ |
| SRO | Eye irritation | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Irritability | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Thermal burns of eye | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release