52A-89470-56767 · OpenVSafe

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-27
Dose 1 — Moderna
2021-04-06
Registered in v-safe
2021-04-06
Survey response — day 7, dose 1
MedDRA: Ear pruritus, Erythema, Rash, Rash pruritic, Scab, Self-medication, Skin warm — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Small bumps on my body very itchy and right ear had bumps that left scabs hot to the touch red outside , still itchy but dried up . Other ear itchy also . I take Benadryl to sleep 2 a night so it seems to get progressively worst in the afternoon as it wears off . This all started Tuesday the 30th of March

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-17
Survey response — day 21, dose 1
MedDRA: Ear swelling, Erythema, Fatigue, Pruritus — Feeling: Fair

Free text: My other ear started to itch and turn red /swollen . And have been very tired in the last week .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — day 28, dose 1
MedDRA: Rash — Feeling: Fair

Free text: Rash spots keep popping up on my body in different spots .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna

Free text

Release 7 — day 7, dose 1

2021-04-06

Systemic reaction (other): Small bumps on my body very itchy and right ear had bumps that left scabs hot to the touch red outside , still itchy but dried up . Other ear itchy also . I take Benadryl to sleep 2 a night so it seems to get progressively worst in the afternoon as it wears off . This all started Tuesday the 30th of March

Release 7 — day 21, dose 1

2021-04-17

Symptoms: My other ear started to itch and turn red /swollen . And have been very tired in the last week .

Release 7 — day 28, dose 1

2021-04-24

Symptoms: Rash spots keep popping up on my body in different spots .

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	Ear swelling	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Ear pruritus	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Scab	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Skin warm	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release