453-18416-99087
1 vaccination
4 coded responses
6 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 238 / VA
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Dose 1 — Moderna
-
2021-03-09
Registered in v-safe
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2021-03-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection siteAdult check-in
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2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Poor · Site: Itching · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Rash all over my bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-11
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Poor · Site: Redness, Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Rash all over bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Urticaria — Feeling: Poor · Site: Redness, Itching · Rash, not including the immediate area around the injection site · Be unable to workFree text: Hives all over bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
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2021-03-13
Survey response — day 7, dose 1MedDRA: Urticaria — Feeling: Poor · Site: Itching · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Hives all over my bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-13
- 2021-03-20
- 2022-03-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-10 | Unsuccessful | |
| 2021-03-11 | Unsuccessful | |
| 2021-03-12 | Unsuccessful | |
| 2021-03-13 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Rash all over my body
Systemic reaction (other): Rash all over body
Systemic reaction (other): Hives all over body
Release 5 — day 7, dose 1
Systemic reaction (other): Hives all over my body
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 |
|---|---|---|---|---|
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release