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
-
2021-01-20
Dose 1 — Moderna
-
2021-01-21
Registered in v-safe
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2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Rash macular — Feeling: Fair · Site: Redness, Itching · Chills, Rash, not including the immediate area around the injection siteFree text: Blotches of redness over chest & both armsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection siteAdult check-in
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2021-01-23
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection siteAdult check-in
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Rash macular — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree 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
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2021-01-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Fever · Chills, Rash, not including the immediate area around the injection siteAdult check-in
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2021-01-26
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-01-27
Survey response — day 7, dose 1MedDRA: 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 activitiesFree 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
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2021-07-21
Survey response — 6 months, dose 1MedDRA: 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 professionalFree 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 & dermatologistMedDRA releases: 2024-11 · check-in free text available
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2021-07-21
Report sent to call center — 6 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-27
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2021-09-13
Dose 2 — Moderna
- 2022-01-20
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2022-02-14
Dose 3 — Pfizer-BioNTech
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2022-02-14
Health check-in — day 0, dose 3Feeling: Good · Site: Redness · Headache, Fatigue or tiredness, Abdominal painAdult check-in
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2022-02-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body aches, Abdominal painAdult check-in
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-09-13 | Moderna | No |
| 3 | 2022-02-14 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Blotches of redness over chest & both arms
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Lupus-like syndrome | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Rosacea | · | · | ✓ |
| SD | Superficial vein prominence | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash macular | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release