SMB-12275-28102
3 vaccinations
1 coded response
23 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 432 / OH
- Registered
- 2021-01-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-10
Registered in v-safe
-
2021-01-10
Dose 1 — Moderna
- 2021-01-10
-
2021-01-11
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-12
- 2021-01-14
- 2021-01-15
- 2021-01-26
- 2021-01-31
-
2021-02-07
Dose 2 — Moderna
- 2021-02-07
-
2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, DiarrheaAdult check-in
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, NauseaAdult check-in
- 2021-02-11
- 2021-02-21
- 2021-02-28
- 2021-03-10
- 2021-03-14
- 2021-03-21
- 2021-05-09
- 2021-08-08
-
2021-11-10
Dose 3 — Moderna
-
2021-11-28
Health check-in — day 14, dose 3Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Hives appeared on 11/22 approximately 11 days after booster. Physician said they are classic drug reaction hives.Adult check-in · check-in free text available
- 2021-12-01
-
2021-12-08
Survey response — day 28, dose 3MedDRA: Mechanical urticaria, Office visit, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Hives continue and have changed into dermographism. Dermatologist confirms that is likely from the booster. · Healthcare visit (other): DermatologistMedDRA releases: 2024-11 · check-in free text available
-
2021-12-08
Report sent to call center — day 28, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-09
-
2021-12-10
Call successfulParticipant prefers to complete VAERS report online
- 2021-12-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-10 | Moderna | |
| 2 | 2021-02-07 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 28, dose 3
Symptoms: Hives continue and have changed into dermographism. Dermatologist confirms that is likely from the booster.
Healthcare visit (other): Dermatologist
Release 12 — day 14, dose 3
Symptoms: Hives appeared on 11/22 approximately 11 days after booster. Physician said they are classic drug reaction 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 | Office visit | · | · | ✓ |
| SD | Mechanical urticaria | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release