6GH-16925-29606

4 vaccinations 10 coded responses 34 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 151 / PA
Registered: 2021-01-29

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-29
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Pre-existing disease, Urticaria — Feeling: Good

Free text: 9 days after the injection, I began experiencing hives. I have had Chronic idiopathic urticaria for 8 years. This may be the beginning of a flare cycle.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 21, dose 1
MedDRA: Condition aggravated, Pre-existing disease, Urticaria — Feeling: Good

Free text: Worsening hives. I am in a flare of Chonic Idiopathic Urticaria.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Urticaria — Feeling: Good · Site: Pain

Free text: Hives are worse than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Urticaria — Feeling: Good

Free text: Hives continue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Urticaria — Feeling: Good

Free text: Hives continue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Urticaria — Feeling: Good

Free text: Hives continue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Urticaria — Feeling: Good

Free text: Hives continue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 7, dose 2
MedDRA: Diarrhoea, Urticaria, Vomiting — Feeling: Good

Free text: Hives continue, unrelated vomiting and diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-04
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Survey response — day 42, dose 2
MedDRA: Dehydration, Diarrhoea, Hospitalisation, Urticaria, Vomiting — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Hives (Chronic Urticaria) flare is still worsening. Taking more meds to try to control it. · Healthcare visit (other): Also hospitalizedt for vomiting/diarrhea/dehydration. Testing shows celiac type damage to stomach, inflammation of duodenum, and rapid gastric emptying.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-27
Dose 3 — Moderna
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2021-12-16
Call successful
Participant prefers to complete VAERS report online
2022-02-27
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-04-22
Dose 4 — Moderna
2022-05-07
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-29
Survey response — day 35, dose 4
MedDRA: Urticaria — Feeling: Fair

Free text: Worsening hives

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-10-21
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-24
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-08-27	Moderna	No
4	2022-04-22	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-12

Symptoms: 9 days after the injection, I began experiencing hives. I have had Chronic idiopathic urticaria for 8 years. This may be the beginning of a flare cycle.

Release 4 — day 21, dose 1

2021-02-19

Symptoms: Worsening hives. I am in a flare of Chonic Idiopathic Urticaria.

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Hives are worse than yesterday

2021-03-01

Systemic reaction (other): Hives continue

2021-03-02

Systemic reaction (other): Hives continue

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Hives continue

2021-03-04

Systemic reaction (other): Hives continue

Release 5 — day 7, dose 2

2021-03-05

Systemic reaction (other): Hives continue, unrelated vomiting and diarrhea

Release 7 — day 42, dose 2

2021-04-09

Symptoms: Hives (Chronic Urticaria) flare is still worsening. Taking more meds to try to control it.

Healthcare visit (other): Also hospitalizedt for vomiting/diarrhea/dehydration. Testing shows celiac type damage to stomach, inflammation of duodenum, and rapid gastric emptying.

Release 11 — day 35, dose 4

2022-05-29

Symptoms: Worsening hives

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	Dehydration	✓	✓	✓
HCVO	Diarrhoea	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Vomiting	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Urticaria	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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