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2NJ-18460-63716

3 vaccinations 4 coded responses 11 check-ins 4 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
959 / CA
Registered
2021-01-21
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-20
    Dose 1 — Moderna
  2. 2021-01-21
    Registered in v-safe
  3. 2021-01-21
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash macular — Feeling: Fair · Site: Redness, Itching · Chills, Rash, not including the immediate area around the injection site
    Free text: Blotches of redness over chest & both arms
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection site
    Adult check-in
  5. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site
    Adult check-in
  6. 2021-01-24
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash macular — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Free text: red blotches on limps & much of body; it's been more than 4 days now and no improvement.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Redness, Itching · Fever · Chills, Rash, not including the immediate area around the injection site
    Adult check-in
  8. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Adult check-in
  9. 2021-01-27
    Survey response — day 7, dose 1
    MedDRA: Erythema, Pruritus, Rash macular — Feeling: Poor · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: It switched from trunk to legs and ankles where the itching is now mostly located. Still red blotches on trunk but does not itch, just the feet. 2X dosage of antihistamine. It has been 1 week since I took the Moderna Vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-07-21
    Survey response — 6 months, dose 1
    MedDRA: Lupus-like syndrome, Medical counselling, Office visit, Rosacea, Superficial vein prominence, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Lupus or Rosacea like symptoms on my face & hives on both arms plus subcutaneous vein streaks on my abdomen. It has not gone away since I took my first Moderna shot back at end of January 2021. I have not taken the 2nd vaccine shot on Dr. Advice. · Healthcare visit (other): saw PCP & dermatologist
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-07-21
    Report sent to call center — 6 months, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-07-27
  13. 2021-09-13
    Dose 2 — Moderna
  14. 2022-01-20
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in
  15. 2022-02-14
    Dose 3 — Pfizer-BioNTech
  16. 2022-02-14
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Redness · Headache, Fatigue or tiredness, Abdominal pain
    Adult check-in
  17. 2022-02-15
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Muscle or body aches, Abdominal pain
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-20Moderna
22021-09-13Moderna No
32022-02-14Pfizer-BioNTech No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): Blotches of redness over chest & both arms

2021-01-24

Systemic reaction (other): red blotches on limps & much of body; it's been more than 4 days now and no improvement.

Release 2 — day 7, dose 1

2021-01-27

Systemic reaction (other): It switched from trunk to legs and ankles where the itching is now mostly located. Still red blotches on trunk but does not itch, just the feet. 2X dosage of antihistamine. It has been 1 week since I took the Moderna Vaccine.

Release 9 — 6 months, dose 1

2021-07-21

Symptoms: Lupus or Rosacea like symptoms on my face & hives on both arms plus subcutaneous vein streaks on my abdomen. It has not gone away since I took my first Moderna shot back at end of January 2021. I have not taken the 2nd vaccine shot on Dr. Advice. cut off by CDC
Healthcare visit (other): saw PCP & dermatologist

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDLupus-like syndrome · · ✓
SDMedical counselling · · ✓
SDRosacea · · ✓
SDSuperficial vein prominence · · ✓
SDUrticaria · · ✓
SROErythema · · ✓
SROPruritus ✓ ✓ ✓
SRORash macular ✓ ✓ ✓

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