33R-16843-17489

3 vaccinations 7 coded responses 10 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 068 / CT
Registered: 2021-11-02

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-23
Dose 1 — Moderna
2021-02-19
Dose 2 — Moderna
2021-10-27
Dose 3 — Moderna
2021-11-02
Registered in v-safe
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Immediate post-injection reaction, Office visit, Pruritus, Rash, Rash pruritic — Feeling: Fair · Site: Pain, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Itching about 30 minutes after injection. This followed 7 months of rash and itching after the 2nd injection in February. · Healthcare visit (other): I saw 4 doctors for the intense itchy rash during the months from March through October

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-03
Survey response — day 7, dose 3
MedDRA: Pruritus — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Itching

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Call 1 — Left Voicemail
2021-11-12
Survey response — day 14, dose 3
MedDRA: Fatigue, Middle insomnia, Poor quality sleep, Pruritus, Rash — Feeling: Poor · Be unable to do your normal daily activities

Free text: More rash and unbearable itching. Extremely tired. Restless sleep with many times awake

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-24
Survey response — day 28, dose 3
MedDRA: Asthenia, Cough, Diarrhoea, Oropharyngeal pain, Pyrexia, Sneezing, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore throat, sneezing, cough, diarrhea, Vomiting, low grade fever and low energy

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-08
Survey response — day 42, dose 3
MedDRA: Office visit, Pruritus, Rash, Rash pruritic — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Itching, rash itching and more rash · Healthcare visit (other): Allergyelemination doctor

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-09
Call 1 — Could Not Reach Participant
2021-12-14
Call 2 — Could Not Reach Participant
2022-01-26
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-27
Survey response — 6 months, dose 3
MedDRA: Fatigue, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Achy all over and extremely tired

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Survey response — 12 months, dose 3
MedDRA: COVID-19, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had COVID. Am tired all the time

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-31
Call 1 — Requested Callback
2022-11-01
Callback requested for
01:00PM ET
2022-11-01
Call successful
Does not wish to fill out VAERS report
2022-11-01
Call successful
Does not wish to fill out VAERS report
2022-11-01
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna	No
2	2021-02-19	Moderna	No
3	2021-10-27	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): Itching about 30 minutes after injection. This followed 7 months of rash and itching after the 2nd injection in February.

Healthcare visit (other): I saw 4 doctors for the intense itchy rash during the months from March through October

Release 10 — day 7, dose 3

2021-11-03

Systemic reaction (other): Itching

Release 10 — day 14, dose 3

2021-11-12

Symptoms: More rash and unbearable itching. Extremely tired. Restless sleep with many times awake

Release 10 — day 28, dose 3

2021-11-24

Symptoms: Sore throat, sneezing, cough, diarrhea, Vomiting, low grade fever and low energy

Release 10 — day 42, dose 3

2021-12-08

Symptoms: Itching, rash itching and more rash

Healthcare visit (other): Allergyelemination doctor

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Achy all over and extremely tired

Release 12 — 12 months, dose 3

2022-10-29

Symptoms: Had COVID. Am tired all the time

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	·	·	✓
HCVO	Rash pruritic	·	·	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Middle insomnia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Poor quality sleep	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Sneezing	·	·	✓
SD	Vomiting	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rash	·	·	✓

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