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38H-23269-09547

4 vaccinations 5 coded responses 24 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
895 / NV
Registered
2021-02-14
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-13
    Dose 1 — Moderna
  2. 2021-02-14
    Registered in v-safe
  3. 2021-02-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pruritus — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities
    Free text: Itching under my arm by edge of breast implant
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-02-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  7. 2021-02-20
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-03-07
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  10. 2021-03-13
    Dose 2 — Moderna
  11. 2021-03-13
    Health check-in — day 0, dose 2
    Feeling: Fair · None
    Adult check-in
  12. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  13. 2021-03-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  14. 2021-03-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-03-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-20
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-03
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-10
    Survey response — day 28, dose 2
    MedDRA: Rash, Transient acantholytic dermatosis — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Yesterday, I was diagnosed with Grovers Disease after having a rash on my torso & back for over 3 weeks. The condition / rash became progressively worse over these 3 weeks so I made a doctors appointment.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-18
    Survey response — day 35, dose 2
    MedDRA: Pre-existing disease — Feeling: Good
    Free text: Continuing to treat Grovers Disease, otherwise feeling good.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-04-24
    Survey response — day 42, dose 2
    MedDRA: Rash — Feeling: Fair
    Free text: Rash is persistent and still using a steroid cream to help get rid of it . I am wondering if the rash is associated with the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-06-12
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-09-13
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-11-14
    Dose 3 — Moderna
  26. 2022-03-16
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2022-10-27
    Dose 4 — Moderna
    Co-administered: Flu
  28. 2022-11-14
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in
  29. 2023-04-30
    Survey response — 6 months, dose 4
    MedDRA: Hypothyroidism, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    MedDRA releases: 2024-11
  30. 2023-04-30
    Report sent to call center — 6 months, dose 4
    Get care from a doctor or other healthcare professional
    1 call case(s)
  31. 2023-05-01
  32. 2023-05-26
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-02-13Moderna
22021-03-13Moderna
32021-11-14Moderna No
42022-10-27Moderna Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Itching under my arm by edge of breast implant

Release 7 — day 28, dose 2

2021-04-10

Symptoms: Yesterday, I was diagnosed with Grovers Disease after having a rash on my torso & back for over 3 weeks. The condition / rash became progressively worse over these 3 weeks so I made a doctors appointment.

Release 7 — day 35, dose 2

2021-04-18

Symptoms: Continuing to treat Grovers Disease, otherwise feeling good.

Release 7 — day 42, dose 2

2021-04-24

Symptoms: Rash is persistent and still using a steroid cream to help get rid of it . I am wondering if the rash is associated with the vaccine.

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 · · ✓
SDHypothyroidism · · ✓
SDPre-existing disease ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDTransient acantholytic dermatosis ✓ ✓ ✓
SROPruritus ✓ ✓ ✓

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

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