62H-11697-44543
2 vaccinations
6 coded responses
24 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 321 / FL
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Dose 1 — Moderna
-
2021-01-29
Registered in v-safe
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: Had to choose fatigue but I'm no worse than usual. Just wanted to share this.Actually my asthma/COPD has been less since vaccine. I was using rescue inhaler every day sometimes multiple times. I've only its it once since vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
-
2021-02-11
Survey response — day 14, dose 1MedDRA: Peripheral swelling, Rash — Feeling: GoodFree text: Area near shot got swollen and rashMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
-
2021-02-25
Dose 2 — Moderna
- 2021-02-25
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Pain in jaw — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Head and jaw painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
-
2021-03-04
Survey response — day 7, dose 2MedDRA: Loss of personal independence in daily activities, Neck pain, Pain in jaw — Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activitiesFree text: Pain in jaw and neck . All about 2am till 6. Was able to do things around house but didn't want to do anything strenuous in case it brought on pain again. So missed outing with friendsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-02
Survey response — day 35, dose 2MedDRA: Contusion, Dyspnoea, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Breathing... rash on and offBruise for no reason on inner right elbowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-05-27
- 2021-08-26
-
2022-02-27
Survey response — 12 months, dose 2MedDRA: No reaction on previous exposure to drug, Office visit, Precancerous skin lesion, Rash — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: After Booster got bad rash on same arm. I heard not that many were getting this. What bothers me is fact I got worse rash same area after flu shot. Never got any symptoms in all my years of getting flu shot. Spot in rash ended up being precancerous · Healthcare visit (other): DermatologistMedDRA releases: 2024-11 · check-in free text available
-
2022-02-27
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-17
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Had to choose fatigue but I'm no worse than usual. Just wanted to share this.Actually my asthma/COPD has been less since vaccine. I was using rescue inhaler every day sometimes multiple times. I've only its it once since vaccine
Release 4 — day 14, dose 1
Symptoms: Area near shot got swollen and rash
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Head and jaw pain
Release 5 — day 7, dose 2
Systemic reaction (other): Pain in jaw and neck . All about 2am till 6. Was able to do things around house but didn't want to do anything strenuous in case it brought on pain again. So missed outing with friends
Release 6 — day 35, dose 2
Symptoms: Breathing... rash on and offBruise for no reason on inner right elbow
Release 11 — 12 months, dose 2
Symptoms: After Booster got bad rash on same arm. I heard not that many were getting this. What bothers me is fact I got worse rash same area after flu shot. Never got any symptoms in all my years of getting flu shot. Spot in rash ended up being precancerous cut off by CDC
Healthcare visit (other): Dermatologist
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 | Contusion | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | No reaction on previous exposure to drug | · | · | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Precancerous skin lesion | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release