65Z-47890-91418
2 vaccinations
15 coded responses
23 check-ins
15 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 600 / IL
- Registered
- 2021-03-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-05
Dose 1 — Moderna
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2021-03-07
Registered in v-safe
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: A dark spot appeared on my chest.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Skin discolouration — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Still have the reddish brownish spot on my chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Site: Pain, ItchingFree text: Reddish/brownish spot on my chest is fadingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: GoodFree text: Reddish brownish spot on chest is going away but is still there.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: GoodFree text: Still have reddish brownish spot on my chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — day 7, dose 1MedDRA: Skin discolouration — Feeling: GoodFree text: Still have reddish brownish spot on my chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — day 14, dose 1MedDRA: Chills, Erythema, Medical counselling, Pain in extremity, Pruritus, Skin warm — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Developed a giant red circle on my arm 8 days after injection. It was hot, red, very itchy, and it hurt too. At night I would get the chills but no fever. · Healthcare visit (other): Went to ask the pharmacist if it was normal and she said yes. Did not examine me though.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-26
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2021-04-02
Dose 2 — Moderna
- 2021-04-02
- 2021-04-04
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2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: GoodFree text: My armpit hurts in the arm I received the vaccine. It hurt yesterday too but didnt think to report itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: GoodFree text: My armpit in the arm that received the shot is soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
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2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Fatigue or tiredness, Nausea, Diarrhea, Abdominal painAdult check-in
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2021-04-09
Survey response — day 7, dose 2MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tirednessFree text: May have a sore in my mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
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2021-04-23
Survey response — day 21, dose 2MedDRA: Burning sensation, Pain in extremity, Pruritus — Feeling: Fair · Be unable to do your normal daily activitiesFree text: 2 weeks & 4 days after my second vaccine dose I came down with an incredibly painful itchiness in both my arms, chest, & breasts. Started on 4/20 in afternoon. 4 days later its starting to feel better. Left arm has a burn itch now. (First dose armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-30
Survey response — day 28, dose 2MedDRA: Feeling cold, Pruritus — Feeling: GoodFree text: Im still feeling itchiness in my arms & chest. My left arm feels like it has menthol on it. That arm was the arm I got the first dose. Also can be very tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-07
Survey response — day 35, dose 2MedDRA: Paraesthesia, Pruritus — Feeling: GoodFree text: My left arm still gets itchy and tingly from my first dose. (My second dose was in my right arm). My chest still gets itchyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-16
Survey response — day 42, dose 2MedDRA: Headache, Pain in extremity — Feeling: GoodFree text: Headaches. Arm from first shot still bothers me on and off.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-02
Survey response — 3 months, dose 2MedDRA: Chest discomfort, Heavy menstrual bleeding, Limb discomfort, Menstrual disorder, Muscle spasms — Feeling: Good · Be unable to do your normal daily activitiesFree text: My arms and chest sometimes feel tight. My menstrual cycle is altered as well. More cramps, heavier periods.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-01
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2021-12-29
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): A dark spot appeared on my chest.
Systemic reaction (other): Still have the reddish brownish spot on my chest
Systemic reaction (other): Reddish/brownish spot on my chest is fading
Systemic reaction (other): Reddish brownish spot on chest is going away but is still there.
Systemic reaction (other): Still have reddish brownish spot on my chest
Release 5 — day 7, dose 1
Systemic reaction (other): Still have reddish brownish spot on my chest
Release 6 — day 14, dose 1
Symptoms: Developed a giant red circle on my arm 8 days after injection. It was hot, red, very itchy, and it hurt too. At night I would get the chills but no fever.
Healthcare visit (other): Went to ask the pharmacist if it was normal and she said yes. Did not examine me though.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): My armpit hurts in the arm I received the vaccine. It hurt yesterday too but didnt think to report it
Systemic reaction (other): My armpit in the arm that received the shot is sore
Release 7 — day 7, dose 2
Systemic reaction (other): May have a sore in my mouth
Release 7 — day 21, dose 2
Symptoms: 2 weeks & 4 days after my second vaccine dose I came down with an incredibly painful itchiness in both my arms, chest, & breasts. Started on 4/20 in afternoon. 4 days later its starting to feel better. Left arm has a burn itch now. (First dose arm
Release 8 — day 28, dose 2
Symptoms: Im still feeling itchiness in my arms & chest. My left arm feels like it has menthol on it. That arm was the arm I got the first dose. Also can be very tired
Release 8 — day 35, dose 2
Symptoms: My left arm still gets itchy and tingly from my first dose. (My second dose was in my right arm). My chest still gets itchy
Release 8 — day 42, dose 2
Symptoms: Headaches. Arm from first shot still bothers me on and off.
Release 9 — 3 months, dose 2
Symptoms: My arms and chest sometimes feel tight. My menstrual cycle is altered as well. More cramps, heavier periods.
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 | Medical counselling | ✓ | ✓ | ✓ |
| SD | Burning sensation | ✓ | ✓ | ✓ |
| SD | Chest discomfort | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Feeling cold | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
| SD | Limb discomfort | ✓ | ✓ | ✓ |
| SD | Menstrual disorder | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Skin discolouration | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release