3UV-27193-61003

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 402 / KY
Registered: 2021-01-09

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

2021-01-06
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Pain in extremity — Feeling: Good · Site: Pain

Free text: Sore left arm and had chills on first day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-01-13
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash erythematous — Feeling: Fair · Fever · Chills, Rash, not including the immediate area around the injection site

Free text: Have a red rash on the neck my arms under my arms my chest my legs and top of my feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Rash erythematous, Rash pruritic — Feeling: Fair · Site: Itching · Headache, Rash, not including the immediate area around the injection site

Free text: Rashes aren't dark red like they were the first day still have one spot that I had from the first shot this is dark dark red they itch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Rash macular — Feeling: Fair · Headache

Free text: Still have the red spots on my body they're starting to fade away but I still have the one spot the dark dark red it's the same spot that I had after the first shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Rash macular — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Most of it's clearing up but I have one spot the the size of a silver dollar that's bright bright red

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 7, dose 2
MedDRA: Erythema, Skin discolouration — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Free text: Still have about 20 spots on my body but the one spot is still like a silver dollar and it's bright red I had it at the same spot on shot one

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 21, dose 2
MedDRA: Erythema — Feeling: Good

Free text: I still have one dark red spots but the other eight or nine or starting to fade

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
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
2021-04-03
Survey response — day 42, dose 2
MedDRA: Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I still have about 20 red spots went to a dermatologist he gave me steroids but I still have the spots · Healthcare visit (other): I went and saw a dermatologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-15
Call 1 — Left Voicemail
2022-02-18
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-18	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Sore left arm and had chills on first day.

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Have a red rash on the neck my arms under my arms my chest my legs and top of my feet

2021-02-21

Systemic reaction (other): Rashes aren't dark red like they were the first day still have one spot that I had from the first shot this is dark dark red they itch

2021-02-23

Systemic reaction (other): Still have the red spots on my body they're starting to fade away but I still have the one spot the dark dark red it's the same spot that I had after the first shot

2021-02-24

Systemic reaction (other): Most of it's clearing up but I have one spot the the size of a silver dollar that's bright bright red

Release 4 — day 7, dose 2

2021-02-25

Systemic reaction (other): Still have about 20 spots on my body but the one spot is still like a silver dollar and it's bright red I had it at the same spot on shot one

Release 5 — day 21, dose 2

2021-03-11

Symptoms: I still have one dark red spots but the other eight or nine or starting to fade

Release 6 — day 42, dose 2

2021-04-03

Symptoms: I still have about 20 red spots went to a dermatologist he gave me steroids but I still have the spots

Healthcare visit (other): I went and saw a dermatologist

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	Erythema	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Skin discolouration	✓	✓	✓

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