295-26521-37102
3 vaccinations
1 coded response
9 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 328 / FL
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Registered dependents
M43-46617-78556
Child or adolescent in my care · Male · 2021-11-29
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-22
Registered in v-safe
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Peripheral swelling, Pruritus, Rash erythematous — Feeling: Fair · 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: My arm is swollen and red rash 6 days after vaccine. Very itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-22
Report sent to call center — day 14, 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)
- 2021-01-29
- 2021-02-05
-
2021-02-08
Dose 2 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-05-31
- 2021-08-11
-
2021-11-12
Dose 3 — Moderna
- 2021-12-03
- 2021-12-10
- 2021-12-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-22 | Unsuccessful |
Free text
Release 2 — day 14, dose 1
Symptoms: My arm is swollen and red rash 6 days after vaccine. Very itchy.
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 |
|---|---|---|---|---|
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release