4VJ-21891-66479
2 vaccinations
4 coded responses
9 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 280 / NC
- Registered
- 2021-05-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-26
Dose 1 — Moderna
-
2021-04-23
Dose 2 — Moderna
-
2021-05-03
Registered in v-safe
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2021-05-03
Survey response — day 7, dose 2MedDRA: Office visit — Feeling: Fair · Site: Pain, Redness, Itching · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professionalFree text: DermotologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-03
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-07
Survey response — day 14, dose 2MedDRA: Fatigue, Paraesthesia, Pre-existing disease, Rash, Rash pruritic, Skin burning sensation, Urticaria — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Fatigue, I have rheumatoid arthritis and after the first dose got a minor case of hives. after second shot hives (or whatever they are) got way worse. Very itchy prickly burning patches of rash all over. Had a biopsy will have results soon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-07-23
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2021-10-24
Survey response — 6 months, dose 2MedDRA: Burning sensation, Condition aggravated, Dermatitis, Pre-existing disease, Pruritus, Rash vesicular — Feeling: Fair · Be unable to work or attend school, 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: I have stated since I got my second dose of the Moderna vaccine I have had a severe case of neuropathy and dermatitis all over my body. I already had neuropathy but the vaccine dialed that and the skin itch, burning and shingle like places 500%.MedDRA releases: 2024-11 · check-in free text available
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2021-10-24
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-26
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2022-04-23
Survey response — 12 months, dose 2MedDRA: Dermatitis, Fatigue, Neuralgia, Pruritus — Feeling: Fair · Be unable to work or attend school, 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: Fatigue and severe dermatitis and nerve pain/itchMedDRA releases: 2024-11 · check-in free text available
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2022-04-23
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-04-25
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 8 — day 7, dose 2
Healthcare visit (other): Dermotologist
Release 8 — day 14, dose 2
Symptoms: Fatigue, I have rheumatoid arthritis and after the first dose got a minor case of hives. after second shot hives (or whatever they are) got way worse. Very itchy prickly burning patches of rash all over. Had a biopsy will have results soon.
Release 10 — 6 months, dose 2
Symptoms: I have stated since I got my second dose of the Moderna vaccine I have had a severe case of neuropathy and dermatitis all over my body. I already had neuropathy but the vaccine dialed that and the skin itch, burning and shingle like places 500%.
Release 11 — 12 months, dose 2
Symptoms: Fatigue and severe dermatitis and nerve pain/itch
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 | Burning sensation | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Dermatitis | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Rash vesicular | · | · | ✓ |
| SD | Skin burning sensation | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release