55Y-28403-95683
5 vaccinations
5 coded responses
24 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 521 / IA
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Registered in v-safe
-
2021-02-26
Dose 1 — Moderna
- 2021-02-26
-
2021-02-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-03
- 2021-03-04
-
2021-03-05
Survey response — day 7, dose 1MedDRA: Rash, Rash pruritic — Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection siteFree text: The rash comes, it itches a few days. Goes away. Then appears somewhere else on my body.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — day 14, dose 1MedDRA: Rash — Feeling: GoodFree text: Still have a small rash that moves around my body but seems much less severe.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Survey response — day 21, dose 1MedDRA: Medical counselling, Rash — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Rash broke out across my chest now. · Healthcare visit (other): Ask doctor and nurse relations what to do.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-28
Survey response — day 28, dose 1MedDRA: Medical counselling, Rash, Rash pruritic, Self-medication — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Still have Arash on my body, on my chest at this time. Itches and have been taking benedryl and using Hydrocortisone. · Healthcare visit (other): Talked to medical staff and doctor since husband works as nurse with them.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-28
Report sent to call center — day 28, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-05
- 2021-04-11
- 2021-05-28
-
2021-07-02
Dose 2 — Moderna
- 2021-08-27
-
2021-12-30
Call successfulParticipant prefers to complete VAERS report online
-
2022-01-06
Dose 3 — Moderna
- 2022-02-26
-
2022-06-23
Dose 4 — Moderna
-
2022-09-29
Dose 5 — Other-Unknown
-
2022-10-11
Health check-in — day 7, dose 5Feeling: Good · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2022-10-13
-
2022-10-20
Survey response — day 21, dose 5MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noiseMedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-12-29
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-07-02 | Moderna | No |
| 3 | 2022-01-06 | Moderna | No |
| 4 | 2022-06-23 | Moderna | No |
| 5 | 2022-09-29 | Other-Unknown | No |
Call center
2 call center cases
2 successful
Free text
Release 5 — day 7, dose 1
Systemic reaction (other): The rash comes, it itches a few days. Goes away. Then appears somewhere else on my body.
Release 5 — day 14, dose 1
Symptoms: Still have a small rash that moves around my body but seems much less severe.
Release 5 — day 21, dose 1
Symptoms: Rash broke out across my chest now.
Healthcare visit (other): Ask doctor and nurse relations what to do.
Release 6 — day 28, dose 1
Symptoms: Still have Arash on my body, on my chest at this time. Itches and have been taking benedryl and using Hydrocortisone.
Healthcare visit (other): Talked to medical staff and doctor since husband works as nurse with them.
Release 12 — day 21, dose 5
Symptoms: Runny noise
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 | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release