4ZQ-19432-56014
4 vaccinations
4 coded responses
20 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 662 / KS
- Registered
- 2021-04-28
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-22
Dose 1 — Moderna
-
2021-04-28
Registered in v-safe
-
2021-04-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-04-29
Health check-in — day 7, dose 1Feeling: Fair · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-05-06
- 2021-05-13
-
2021-05-20
Dose 2 — Moderna
- 2021-05-20
- 2021-05-22
-
2021-05-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-05-24
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: Continue to have gradual appearance of generalized rash. Similar to first vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-25
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: Same as yesterday. A few new bumps.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-05-28
Survey response — day 7, dose 2MedDRA: Injection site pain, Rash — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: Failed to mention the pain at site for approx. 3-4 days. Rash remains. No new lesions today as of yet.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-04
- 2021-06-12
-
2021-06-19
Survey response — day 28, dose 2MedDRA: Rash — Feeling: FairFree text: I continue to have the generalized rash. There are days when new rash lesions appear on various areas of my body. This has been a long journey :(. I have not seen a physician regarding this, but am now contemplating it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-25
- 2021-07-05
- 2021-08-19
- 2021-11-20
-
2021-12-30
Dose 3 — Moderna
- 2022-05-22
-
2022-07-17
Dose 4 — Moderna
- 2022-10-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-22 | Moderna | |
| 2 | 2021-05-20 | Moderna | |
| 3 | 2021-12-30 | Moderna | No |
| 4 | 2022-07-17 | Moderna | No |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Continue to have gradual appearance of generalized rash. Similar to first vaccination.
Systemic reaction (other): Same as yesterday. A few new bumps.
Release 8 — day 7, dose 2
Systemic reaction (other): Failed to mention the pain at site for approx. 3-4 days. Rash remains. No new lesions today as of yet.
Release 9 — day 28, dose 2
Symptoms: I continue to have the generalized rash. There are days when new rash lesions appear on various areas of my body. This has been a long journey :(. I have not seen a physician regarding this, but am now contemplating it.
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 |
|---|---|---|---|---|
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release