3QD-25919-31738
3 vaccinations
2 coded responses
3 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 100 / NY
- Registered
- 2021-12-12
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Dose 1 — Moderna
-
2021-02-27
Dose 2 — Moderna
-
2021-11-21
Dose 3 — Moderna
-
2021-12-12
Registered in v-safe
-
2021-12-14
Survey response — day 21, dose 3MedDRA: Urticaria — Feeling: FairFree text: I have hives that developed 12 days after the booster. I know 3 other people with the same symptoms, all who had the Moderna booster. I have no known allergies.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-19
-
2021-12-28
Survey response — day 35, dose 3MedDRA: Rash, Unevaluable event, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: The hives that I have have worsened. They were getting better because I was taking prednisone. I've run out of the medication and the rash has flared up significantly. · Healthcare visit (other): I left a message for the doctor. I'm out of town and can't get in touch another way.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-28
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-30
-
2022-01-03
Call successfulReported to VAERS voluntarily prior to GDIT contact
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | No |
| 2 | 2021-02-27 | Moderna | No |
| 3 | 2021-11-21 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 10 — day 21, dose 3
Symptoms: I have hives that developed 12 days after the booster. I know 3 other people with the same symptoms, all who had the Moderna booster. I have no known allergies.
Release 10 — day 35, dose 3
Symptoms: The hives that I have have worsened. They were getting better because I was taking prednisone. I've run out of the medication and the rash has flared up significantly.
Healthcare visit (other): I left a message for the doctor. I'm out of town and can't get in touch another way.
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 | Unevaluable event | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release