4S3-16540-45762
2 vaccinations
4 coded responses
8 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 490 / MI
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-02-12
Registered in v-safe
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2021-02-12
Dose 2 — Moderna
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2021-02-12
Survey response — day 0, dose 2MedDRA: Discomfort, Medical observation, Rash — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): The rash on my face &. Chest seems to be getting worse. I had to see a dermatologist twice because of the discomfort. · Healthcare visit (other): Office visitsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Report sent to call center — day 0, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Medical counselling, Office visit, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Office visit with dermatologist &phone consultation via phone with my personal physician. I did not get the 3nd moderns on the advice of my personal physician because of the continuing eruptions of hivesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
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2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
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2021-03-07
Survey response — day 21, dose 2MedDRA: Dry eye, Office visit, Rash, Reading disorder — Feeling: Poor · Get care from a doctor or other healthcare professionalFree text: Symptoms: Continued rash on my face-both sides. I have exceedingly dry eyes making reading difficult I have had to see 2 doctors I have had out of pocket expenses. I now have a case number with Moderna. Also because of these issues I did Not get the second · Healthcare visit (other): Doctors officeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-19
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2021-05-14
Survey response — 3 months, dose 2MedDRA: Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Rash, bilateral erosion on my corneas. Both of these issues have required physicians careMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-14
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-15
- 2021-08-13
- 2021-11-12
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2021-11-13
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 4
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): The rash on my face &. Chest seems to be getting worse. I had to see a dermatologist twice because of the discomfort.
Healthcare visit (other): Office visits
Release 4 — days 1–6 daily, dose 2
Healthcare visit (other): Office visit with dermatologist &phone consultation via phone with my personal physician. I did not get the 3nd moderns on the advice of my personal physician because of the continuing eruptions of hives
Release 5 — day 21, dose 2
Symptoms: Continued rash on my face-both sides. I have exceedingly dry eyes making reading difficult I have had to see 2 doctors I have had out of pocket expenses. I now have a case number with Moderna. Also because of these issues I did Not get the second cut off by CDC
Healthcare visit (other): Doctors office
Release 8 — 3 months, dose 2
Symptoms: Rash, bilateral erosion on my corneas. Both of these issues have required physicians care
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Medical observation | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Urticaria | ✓ | ✓ | ✓ |
| SD | Dry eye | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Reading disorder | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release