Y86-11919-19733
3 vaccinations
8 coded responses
38 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 911 / CA
- Registered
- 2021-03-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-25
Registered in v-safe
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2021-03-25
Dose 1 — Moderna
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-30
- 2021-03-31
- 2021-04-01
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2021-04-08
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site rash, Lymphadenopathy — Feeling: GoodFree text: At exactly one week after vaccine, and for only 24hrs I had under arm linfonodos visible enlarged and a circle red skin rash around the site of vaccination. Both symptoms lasted 24hr.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
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2021-04-17
Pregnancy registry surveyNot pregnant at or since vaccination ·
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2021-04-22
Dose 2 — Moderna
- 2021-04-22
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2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tirednessAdult check-in
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2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Hypotension, Oral herpes — Feeling: Fair · Fatigue or tirednessFree text: Low blood pressure (99/66) and developed cold sores, which I usually have every times in awhile but this time they were much more and stronger.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-26
Survey response — days 1–6 daily, dose 2MedDRA: Oral herpes — Feeling: FairFree text: I got cold sores, from yesterday to today developed very badly all over my mouth and noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Survey response — days 1–6 daily, dose 2MedDRA: Oral herpes, Pre-existing disease, Rhinalgia, Stomatitis — Feeling: GoodFree text: I am still dealing with the cold sores outbreak that started after the vaccine. I have cold sores in and out of the mouth and in the nose. My doctor prescribed prednisone and valacyclovirMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — days 1–6 daily, dose 2MedDRA: Oral herpes — Feeling: GoodFree text: Getting better with cold soresMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-07
- 2021-05-13
- 2021-05-20
- 2021-06-01
- 2021-06-03
- 2021-07-22
- 2021-10-21
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2021-11-19
Dose 3 — Moderna
- 2021-11-19
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2021-11-20
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-25
- 2021-11-26
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2021-12-03
Survey response — day 14, dose 3MedDRA: Office visit, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Skin rash all over the body, had to visit the urgent care and currently getting corticosteroids orally.MedDRA releases: 2024-11 · check-in free text available
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2021-12-10
Survey response — day 21, dose 3MedDRA: Office visit, Skin disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Skin Rush · Healthcare visit (other): Visited urgent care first then my dermatologistMedDRA releases: 2024-11 · check-in free text available
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2021-12-10
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-13
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2021-12-16
Call successfulParticipant prefers to complete VAERS report online
- 2021-12-17
- 2021-12-28
- 2021-12-31
- 2022-02-18
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2022-11-19
Survey response — 12 months, dose 3MedDRA: Chills, Headache, Nausea, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Chills, fever, nausea, headacheMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | |
| 2 | 2021-04-22 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-10 | Successful 2021-12-16 |
Participant prefers to complete VAERS report online |
Free text
Release 7 — day 14, dose 1
Symptoms: At exactly one week after vaccine, and for only 24hrs I had under arm linfonodos visible enlarged and a circle red skin rash around the site of vaccination. Both symptoms lasted 24hr.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Low blood pressure (99/66) and developed cold sores, which I usually have every times in awhile but this time they were much more and stronger.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I got cold sores, from yesterday to today developed very badly all over my mouth and nose
Systemic reaction (other): I am still dealing with the cold sores outbreak that started after the vaccine. I have cold sores in and out of the mouth and in the nose. My doctor prescribed prednisone and valacyclovir
Systemic reaction (other): Getting better with cold sores
Release 10 — day 14, dose 3
Symptoms: Skin rash all over the body, had to visit the urgent care and currently getting corticosteroids orally.
Release 10 — day 21, dose 3
Symptoms: Skin Rush
Healthcare visit (other): Visited urgent care first then my dermatologist
Release 12 — 12 months, dose 3
Symptoms: Chills, fever, nausea, headache
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 | Chills | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Skin disorder | · | · | ✓ |
| SRO | Hypotension | ✓ | ✓ | ✓ |
| SRO | Oral herpes | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rhinalgia | ✓ | ✓ | ✓ |
| SRO | Stomatitis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release