2XF-10013-45963
4 vaccinations
2 coded responses
22 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 193 / PA
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-03-17
Registered in v-safe
-
2021-03-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-18
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
-
2021-04-27
Dose 2 — Moderna
- 2021-04-27
- 2021-06-15
- 2021-07-27
- 2021-10-26
-
2021-11-11
Dose 3 — Pfizer-BioNTechCo-administered: Flu
-
2022-04-06
Dose 4 — Moderna
- 2022-04-27
-
2022-04-27
Survey response — 12 months, dose 2MedDRA: Immunisation reaction, Rash — Feeling: GoodFree text: Full body rash, exceptions being face, armpits and groin. Lasted for 3 months. No history of any rash, allergies or eczema. COVID toes affecting big toe and two adjacent on right foot, lasting 5 months.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
- 2022-05-11
- 2022-05-18
-
2022-07-06
Survey response — 3 months, dose 4MedDRA: Contusion, Rash, Rash papular, SARS-CoV-2 test negative, Skin discharge, Unevaluable event — Feeling: GoodFree text: Multiples rash types (raised, bruised, pinprick and a small amount of clear drainage) from shoulders to toes. Rash started on lower legs. Tested negative for COVID-19 twice within 3-5 month duration of rash. Tested by dermatologist, no allergies.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-05
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-27 | Moderna | |
| 3 | 2021-11-11 | Pfizer-BioNTech | Flu |
| 4 | 2022-04-06 | Moderna | No |
Free text
Release 11 — 12 months, dose 2
Symptoms: Full body rash, exceptions being face, armpits and groin. Lasted for 3 months. No history of any rash, allergies or eczema. COVID toes affecting big toe and two adjacent on right foot, lasting 5 months.
Release 12 — 3 months, dose 4
Symptoms: Multiples rash types (raised, bruised, pinprick and a small amount of clear drainage) from shoulders to toes. Rash started on lower legs. Tested negative for COVID-19 twice within 3-5 month duration of rash. Tested by dermatologist, no allergies.
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 | Contusion | · | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash papular | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Skin discharge | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release