2CY-16033-61366

3 vaccinations 9 coded responses 11 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 021 / MA
Registered: 2021-01-21

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-22
Dose 1 — Moderna
2021-01-19
Dose 2 — Moderna
2021-01-21
Registered in v-safe
2021-01-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-22
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylaxis treatment, Emergency care — Feeling: Poor · Site: Pain · Headache, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Treatment for anaphylaxis at local ED

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylaxis treatment — Feeling: Poor · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Required utilization of epinephrine and initiation of prednisone course yesterday; continuing on prednisone course today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylactoid reaction — Feeling: Fair · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Continuing on prednisone and Benadryl s/o treatment for Anaphylactoid reaction thought to be related to vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-01-26
Survey response — day 7, dose 2
MedDRA: Anaphylactic reaction — Feeling: Fair · Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Continuing to take prednisone for presumed anaphylactic reaction to Moderna dose #2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — day 14, dose 2
MedDRA: Anaphylactic reaction, Emergency care — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Seen by allergy/immunology- confirmed anaphylaxis with Dose 2 of Moderna vaccine · Healthcare visit (other): Previous ER visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Survey response — day 21, dose 2
MedDRA: Anaphylactic reaction, Medical counselling, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Still have not been out reached re: confirmed anaphylaxis after second vaccine dose · Healthcare visit (other): Upcoming skin testing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — day 35, dose 2
MedDRA: Anaphylactic reaction — Feeling: Fair

Free text: Note- my anaphylaxis report has not been followed up on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 42, dose 2
MedDRA: Anaphylactic reaction — Feeling: Fair

Free text: Anaphylaxis as mentioned on 1/22 after dose 2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Call successful
Does not wish to fill out VAERS report
2021-07-22
Survey response — 6 months, dose 2
MedDRA: Angioedema, Urticaria chronic — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Chronic urticaria and angioedema after vaccination

MedDRA releases: 2024-11 · check-in free text available
2021-07-22
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-24
Call 1 — Left Voicemail
2021-12-17
Dose 3 — Pfizer-BioNTech

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-22	Moderna
2	2021-01-19	Moderna
3	2021-12-17	Pfizer-BioNTech	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-22

Healthcare visit (other): Treatment for anaphylaxis at local ED

2021-01-23

Systemic reaction (other): Required utilization of epinephrine and initiation of prednisone course yesterday; continuing on prednisone course today

2021-01-24

Systemic reaction (other): Continuing on prednisone and Benadryl s/o treatment for Anaphylactoid reaction thought to be related to vaccine

Release 2 — day 7, dose 2

2021-01-26

Systemic reaction (other): Continuing to take prednisone for presumed anaphylactic reaction to Moderna dose #2

Release 3 — day 14, dose 2

2021-02-02

Symptoms: Seen by allergy/immunology- confirmed anaphylaxis with Dose 2 of Moderna vaccine

Healthcare visit (other): Previous ER visit

Release 4 — day 21, dose 2

2021-02-10

Symptoms: Still have not been out reached re: confirmed anaphylaxis after second vaccine dose

Healthcare visit (other): Upcoming skin testing

Release 4 — day 35, dose 2

2021-02-23

Symptoms: Note- my anaphylaxis report has not been followed up on

Release 5 — day 42, dose 2

2021-03-04

Symptoms: Anaphylaxis as mentioned on 1/22 after dose 2

Release 9 — 6 months, dose 2

2021-07-22

Symptoms: Chronic urticaria and angioedema after vaccination

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	Anaphylaxis treatment	✓	✓	✓
HCVO	Emergency care	✓	✓	✓
HCVO	Medical counselling	✓	✓	○
HCVO	Unevaluable event	·	·	✓
SD	Anaphylactic reaction	✓	✓	✓
SD	Angioedema	·	·	✓
SD	Urticaria chronic	·	·	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Anaphylactoid reaction	✓	✓	✓
SRO	Anaphylaxis treatment	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release