5NX-24212-26653
2 vaccinations
2 coded responses
25 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 980 / WA
- Registered
- 2021-04-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-02
Dose 1 — Moderna
-
2021-04-03
Registered in v-safe
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
-
2021-04-16
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash — Feeling: GoodFree text: Minor rash on my arm near the injection site. It appeared 8 days after my first shot and lasted about 2 days, mostly cleared up but not completely (still faintly visible but not itchy), and is coming back a little today with mild itchiness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-30
-
2021-05-01
Dose 2 — Moderna
- 2021-05-01
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-05-03
- 2021-05-04
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-06-05
- 2021-06-12
-
2021-07-31
Survey response — 3 months, dose 2MedDRA: Eyelid cyst, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: No COVID symptoms. I developed a small cyst on my right eye. It is not painful or bothersome, just unusual. Doctor recommended just to watch it for now, unless something changes or becomes painful. · Healthcare visit (other): In person visit to eye doctors officeMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-31
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-16
-
2021-08-17
Call successfulParticipant prefers to complete VAERS report online
- 2021-10-30
- 2022-05-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna | |
| 2 | 2021-05-01 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — day 14, dose 1
Symptoms: Minor rash on my arm near the injection site. It appeared 8 days after my first shot and lasted about 2 days, mostly cleared up but not completely (still faintly visible but not itchy), and is coming back a little today with mild itchiness.
Release 9 — 3 months, dose 2
Symptoms: No COVID symptoms. I developed a small cyst on my right eye. It is not painful or bothersome, just unusual. Doctor recommended just to watch it for now, unless something changes or becomes painful.
Healthcare visit (other): In person visit to eye doctors office
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 | Eyelid cyst | ✓ | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release