ZRY-23463-66220
1 vaccination
4 coded responses
14 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 601 / IL
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
J8N-15497-25104
Child or adolescent in my care · Female · 2021-11-24
Timeline
-
2021-04-07
Dose 1 — Moderna
-
2021-04-08
Registered in v-safe
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2021-04-08
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Erythema, Immediate post-injection reaction, Pruritus, Throat irritation, Tongue pruritus — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: I experienced itching and redness in my face, itchy throat and tongue, chest tightness 30 minutes after receiving the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Survey response — days 1–6 daily, dose 1MedDRA: Emergency care, Palpitations, Tremor — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): Had uncontrollable shaking and racing heart last night · Healthcare visit (other): Also called 911 last night due to the shaking and heart symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-10
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-04-11
- 2021-04-12
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2021-04-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-14
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2021-04-21
Survey response — day 14, dose 1MedDRA: Pharyngeal swelling, Pruritus, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Widespread faint rash and itching. Throat swelling if I dont take an antihistamine regularly.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-28
Survey response — day 21, dose 1MedDRA: Headache, Hypersensitivity, Pre-existing disease, Pruritus, Self-medication, Skin burning sensation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have continued to struggle with extreme allergy symptoms that Ive never dealt with before. I have a burning and itching under the skin on my face and my scalp. Eating and cooking foods have also made allergy symptoms flare. Taking Zyrtec daily.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-05
- 2021-05-12
- 2021-07-07
- 2021-10-06
- 2022-02-15
- 2022-02-18
- 2022-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-07 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-09 | Unsuccessful | |
| 2021-04-21 | Unsuccessful | |
| 2021-04-28 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): I experienced itching and redness in my face, itchy throat and tongue, chest tightness 30 minutes after receiving the vaccine
Systemic reaction (other): Had uncontrollable shaking and racing heart last night
Healthcare visit (other): Also called 911 last night due to the shaking and heart symptoms
Release 7 — day 14, dose 1
Symptoms: Widespread faint rash and itching. Throat swelling if I dont take an antihistamine regularly.
Release 8 — day 21, dose 1
Symptoms: I have continued to struggle with extreme allergy symptoms that Ive never dealt with before. I have a burning and itching under the skin on my face and my scalp. Eating and cooking foods have also made allergy symptoms flare. Taking Zyrtec daily.
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 | Emergency care | ✓ | ✓ | ✓ |
| HCVO | Tremor | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Pharyngeal swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Skin burning sensation | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
| SRO | Tongue pruritus | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release