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63K-10456-12410

2 vaccinations 7 coded responses 8 check-ins 7 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
606 / IL
Registered
2021-03-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-03
    Dose 1 — Moderna
  2. 2021-03-03
    Dose 2 — Moderna
  3. 2021-03-12
    Registered in v-safe
  4. 2021-03-12
    Survey response — day 7, dose 2
    MedDRA: Chills, Injection site pain, Pain — Feeling: Good
    Free text: I did have a lot of pain at the injection site after Dose 1, and intense pain all over and persistent chills after Dose 2.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-17
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  6. 2021-03-24
    Survey response — day 21, dose 2
    MedDRA: Abdominal distension, Appetite disorder, Oral herpes, Urticaria — Feeling: Fair
    Free text: I have hives and, for the first time ever, cold sores on my lip and in my mouth. I am also experiencing unusual (for me) digestive issues (mildly painful bloating).I have very little appetite.Ive not changed my diet, sleep, or exercisE habits.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-31
    Survey response — day 28, dose 2
    MedDRA: Hepatic pain, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: I have a fairly severe pain in my liver. It's a shooting pain, and it also hurts when I move. It started about 24 hours ago. I am taking Advil, and it is helping a little bit (but I am still in pain).
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-08
    Survey response — day 35, dose 2
    MedDRA: Hepatic pain, Urticaria — Feeling: Fair · Be unable to do your normal daily activities
    Free text: My liver pain increased, and I continue to have outbreaks of hives. Initially they were only on my left side, but now they have spread to my right side.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-14
    Survey response — day 42, dose 2
    MedDRA: Hepatic pain, Urticaria — Feeling: Fair · Be unable to do your normal daily activities
    Free text: I am getting new hives almost daily still. Now, they are on my right side only. My liver pain is less, but still persists.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-06-02
    Survey response — 3 months, dose 2
    MedDRA: Mouth ulceration, Urticaria — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: My hives were VERY persistent for 6 full weeks. They are gone now. I now have a painful ulcer (I eat quite well and have no other mitigating conditions or lifestyle issues like drinking, smoking, etc.). I will be seeking doctor's care next week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-09-01
    Survey response — 6 months, dose 2
    MedDRA: Nausea, Office visit, Urticaria — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: I have had persistent nauseamost days I have experienced at least a mild episodebut without any other recognizable cause. My hives are gone for the most part. I did end up with six solid weeks of hive breakouts, so I am grateful they are gone · Healthcare visit (other): I went to see my primary care physician.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  12. 2021-09-01
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-09-06
  14. 2021-09-08
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-02-03Moderna
22021-03-03Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): I did have a lot of pain at the injection site after Dose 1, and intense pain all over and persistent chills after Dose 2.

Release 6 — day 21, dose 2

2021-03-24

Symptoms: I have hives and, for the first time ever, cold sores on my lip and in my mouth. I am also experiencing unusual (for me) digestive issues (mildly painful bloating).I have very little appetite.Ive not changed my diet, sleep, or exercisE habits.

Release 6 — day 28, dose 2

2021-03-31

Symptoms: I have a fairly severe pain in my liver. It's a shooting pain, and it also hurts when I move. It started about 24 hours ago. I am taking Advil, and it is helping a little bit (but I am still in pain).

Release 7 — day 35, dose 2

2021-04-08

Symptoms: My liver pain increased, and I continue to have outbreaks of hives. Initially they were only on my left side, but now they have spread to my right side.

Release 7 — day 42, dose 2

2021-04-14

Symptoms: I am getting new hives almost daily still. Now, they are on my right side only. My liver pain is less, but still persists.

Release 8 — 3 months, dose 2

2021-06-02

Symptoms: My hives were VERY persistent for 6 full weeks. They are gone now. I now have a painful ulcer (I eat quite well and have no other mitigating conditions or lifestyle issues like drinking, smoking, etc.). I will be seeking doctor's care next week.

Release 9 — 6 months, dose 2

2021-09-01

Symptoms: I have had persistent nauseamost days I have experienced at least a mild episodebut without any other recognizable cause. My hives are gone for the most part. I did end up with six solid weeks of hive breakouts, so I am grateful they are gone
Healthcare visit (other): I went to see my primary care physician.

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ · ✓
SDAbdominal distension ✓ ✓ ✓
SDAppetite disorder ✓ ✓ ✓
SDHepatic pain ✓ ✓ ✓
SDMouth ulceration ✓ ✓ ✓
SDNausea ✓ · ✓
SDOral herpes ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDUrticaria ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPain ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release