YU3-48432-50379
2 vaccinations
3 coded responses
13 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 112 / NY
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-24
Registered in v-safe
-
2021-01-24
Dose 1 — Moderna
-
2021-01-25
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-31
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2021-02-07
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site urticaria — Feeling: GoodFree text: A red hive-type spot around the vaccine site emerged and was slightly itchy. Has receded now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-16
Survey response — day 21, dose 1MedDRA: Office visit, Urticaria — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Hives outbreak · Healthcare visit (other): Visit to a specialistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-16
Report sent to call center — day 21, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-22
Dose 2 — Moderna
- 2021-02-26
- 2021-02-27
- 2021-03-01
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2021-03-08
Survey response — day 14, dose 2MedDRA: Skin reaction, Urticaria — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I had a recurrence of a hives skin reaction, 9-12 days after the second shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-17
- 2021-03-29
- 2021-04-27
- 2021-05-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-24 | Moderna | |
| 2 | 2021-02-22 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-16 | Unsuccessful | |
| 2021-03-08 | Unsuccessful |
Free text
Release 3 — day 14, dose 1
Symptoms: A red hive-type spot around the vaccine site emerged and was slightly itchy. Has receded now.
Release 4 — day 21, dose 1
Release 5 — day 14, dose 2
Symptoms: I had a recurrence of a hives skin reaction, 9-12 days after the second shot.
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 | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site urticaria | ✓ | ✓ | ✓ |
| SD | Skin reaction | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release