5YM-19302-42994
3 vaccinations
4 coded responses
25 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 321 / FL
- Registered
- 2021-01-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Registered in v-safe
-
2021-01-08
Dose 1 — Moderna
- 2021-01-09
-
2021-01-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-01-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-16
- 2021-01-24
- 2021-01-31
-
2021-02-04
Dose 2 — Moderna
-
2021-02-11
Survey response — day 7, dose 2MedDRA: Aphthous ulcer, Oral herpes — Feeling: Good · Site: Pain · Muscle or body achesFree text: Canker sores & cold soresMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
- 2021-02-25
- 2021-03-05
- 2021-03-13
- 2021-03-18
- 2021-05-08
- 2021-08-05
-
2021-11-02
Dose 3 — Moderna
-
2021-11-18
Survey response — day 14, dose 3MedDRA: Emergency care, Pruritus, Urticaria — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I developed hives 2 weeks after my 3rd dose. Hands, feet and all over my body. It itches. I went to ER. Got prescription for prednisone, famotidine and BenadrylMedDRA releases: 2024-11 · check-in free text available
-
2021-11-18
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2021-11-18
Call successfulReported to VAERS voluntarily prior to GDIT contact
-
2021-11-23
Survey response — day 21, dose 3MedDRA: Emergency care, Erythema, Pruritus, Rash, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: hives/rash turned purplish black last night, for about 2 hours. I went to ER. They took blood samples. No infection. The purple/black color went away. This morning my hands and feet are itchy and red.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-23
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2021-11-24
Call successfulDoes not wish to fill out VAERS report
- 2021-11-30
- 2021-12-07
- 2021-12-15
-
2022-02-01
Survey response — 3 months, dose 3MedDRA: Self-medication, Urticaria — Feeling: FairFree text: I still have hives since I got the booster back in November 2021. I've been taking Allegra & Benadryl almost daily.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
- 2022-11-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 1
Free text
Release 4 — day 7, dose 2
Systemic reaction (other): Canker sores & cold sores
Release 10 — day 14, dose 3
Symptoms: I developed hives 2 weeks after my 3rd dose. Hands, feet and all over my body. It itches. I went to ER. Got prescription for prednisone, famotidine and Benadryl
Release 10 — day 21, dose 3
Symptoms: hives/rash turned purplish black last night, for about 2 hours. I went to ER. They took blood samples. No infection. The purple/black color went away. This morning my hands and feet are itchy and red.
Release 11 — 3 months, dose 3
Symptoms: I still have hives since I got the booster back in November 2021. I've been taking Allegra & Benadryl almost daily.
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 |
|---|---|---|---|---|
| SD | Emergency care | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Aphthous ulcer | ✓ | ✓ | ✓ |
| SRO | Oral herpes | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release