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
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2021-02-03
Dose 1 — Moderna
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2021-03-03
Dose 2 — Moderna
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2021-03-12
Registered in v-safe
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2021-03-12
Survey response — day 7, dose 2MedDRA: Chills, Injection site pain, Pain — Feeling: GoodFree 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
- 2021-03-17
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2021-03-24
Survey response — day 21, dose 2MedDRA: Abdominal distension, Appetite disorder, Oral herpes, Urticaria — Feeling: FairFree 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
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2021-03-31
Survey response — day 28, dose 2MedDRA: Hepatic pain, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree 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
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2021-04-08
Survey response — day 35, dose 2MedDRA: Hepatic pain, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
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2021-04-14
Survey response — day 42, dose 2MedDRA: Hepatic pain, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
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2021-06-02
Survey response — 3 months, dose 2MedDRA: Mouth ulceration, Urticaria — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree 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
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2021-09-01
Survey response — 6 months, dose 2MedDRA: Nausea, Office visit, Urticaria — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree 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
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2021-09-01
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-06
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2021-09-08
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 5 — day 7, dose 2
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
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
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
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
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | · | ✓ |
| SD | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Appetite disorder | ✓ | ✓ | ✓ |
| SD | Hepatic pain | ✓ | ✓ | ✓ |
| SD | Mouth ulceration | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | · | ✓ |
| SD | Oral herpes | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release