3UP-10753-25924

3 vaccinations 5 coded responses 25 check-ins 5 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 940 / CA
Registered: 2021-02-19

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

2021-01-20
Dose 1 — Moderna
2021-02-18
Dose 2 — Moderna
2021-02-19
Registered in v-safe
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Joint pains

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Chills

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Dose 3 — Moderna
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-17
Survey response — days 1–6 daily, dose 3
MedDRA: Pruritus — Feeling: Good · Site: Itching

Free text: Itching in feet, wrists, back and waist areas mostly feet, and it's been since my first MODERNA shot in January

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 7, dose 3
MedDRA: Pruritus — Feeling: Good · Site: Itching

Free text: Crazy itching on tops of feet, upper thigh, wrists and neck

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-23
Survey response — day 42, dose 3
MedDRA: Injection site pruritus, Medical counselling, Office visit, Sensitive skin — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Very sensitive itching all over. Dermatologist said some bacteria and some viruses been since booster shot. · Healthcare visit (other): Dr office visit

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-27
Call successful
Participant prefers to complete VAERS report online
2022-02-11
Survey response — 3 months, dose 3
MedDRA: Office visit, Pruritus, Rash — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Itching and rash on legs and back and chest and arms dermatologist treated steroids now 85% calm but not cured yet could be coincidence however started in January 22, booster 11/1/21. · Healthcare visit (other): Dermatologist

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-21
Call successful
Participant prefers to complete VAERS report online
2022-11-11
Survey response — 12 months, dose 3
MedDRA: Office visit, Pruritus, Reaction to previous exposure to any vaccine, Transient acantholytic dermatosis — Feeling: Good

Free text: Very itchy forearms and ankles nightly after last the new booster? dermatologist thinks Grover's disease? happened after the 2 Covid shot too last year?

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-18	Moderna
3	2021-11-11	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-17

Systemic reaction (other): Itching in feet, wrists, back and waist areas mostly feet, and it's been since my first MODERNA shot in January

Release 10 — day 7, dose 3

2021-11-18

Systemic reaction (other): Crazy itching on tops of feet, upper thigh, wrists and neck

Release 10 — day 42, dose 3

2021-12-23

Symptoms: Very sensitive itching all over. Dermatologist said some bacteria and some viruses been since booster shot.

Healthcare visit (other): Dr office visit

Release 11 — 3 months, dose 3

2022-02-11

Symptoms: Itching and rash on legs and back and chest and arms dermatologist treated steroids now 85% calm but not cured yet could be coincidence however started in January 22, booster 11/1/21.

Healthcare visit (other): Dermatologist

Release 12 — 12 months, dose 3

2022-11-11

Symptoms: Very itchy forearms and ankles nightly after last the new booster? dermatologist thinks Grover's disease? happened after the 2 Covid shot too last year?

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	Injection site pruritus	·	·	✓
SD	Medical counselling	·	·	✓
SD	Office visit	·	·	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Sensitive skin	·	·	✓
SD	Transient acantholytic dermatosis	·	·	✓
SRO	Pruritus	·	·	✓

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