4K2-24001-04478
1 vaccination
3 coded responses
11 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 850 / AZ
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
- 2021-03-17
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
-
2021-03-31
Survey response — day 14, dose 1MedDRA: Pruritus, Rash — Feeling: GoodFree text: Whole body very itchy. Started a couple of days ago. Slight rash on back, but otherwise just itchy. Have not changed any products.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Survey response — day 21, dose 1MedDRA: Erythema, Office visit, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Body itching. No rash. Approximately 7 days ago a strange red circle appeared on top of my left foot. Not sure if it is related to vaccine or not. Did see doctor today and she directed me to dermatologist. · Healthcare visit (other): Dr visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-16
Survey response — 3 months, dose 1MedDRA: Herpes zoster, No adverse event, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: I feel fine, but my husband had vaccine on same days and now has Shingles. Started on same side as shot. Neck, shoulder, left side of back. Related to vaccine?? He has had Shingles for a month now. · Healthcare visit (other): Doctor visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-16
Report sent to call center — 3 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-18
- 2021-09-15
- 2022-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna |
Call center
2 call center cases
2 unsuccessful
Free text
Release 6 — day 14, dose 1
Symptoms: Whole body very itchy. Started a couple of days ago. Slight rash on back, but otherwise just itchy. Have not changed any products.
Release 7 — day 21, dose 1
Symptoms: Body itching. No rash. Approximately 7 days ago a strange red circle appeared on top of my left foot. Not sure if it is related to vaccine or not. Did see doctor today and she directed me to dermatologist.
Healthcare visit (other): Dr visit
Release 9 — 3 months, dose 1
Symptoms: I feel fine, but my husband had vaccine on same days and now has Shingles. Started on same side as shot. Neck, shoulder, left side of back. Related to vaccine?? He has had Shingles for a month now.
Healthcare visit (other): Doctor visit
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 | Herpes zoster | ✓ | ✓ | ○ |
| SD | No adverse event | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release