5RP-73908-91850
2 vaccinations
3 coded responses
15 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 038 / NH
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-02-12
Registered in v-safe
-
2021-02-12
Dose 2 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-20
- 2021-02-28
- 2021-03-05
- 2021-03-12
- 2021-03-19
-
2021-05-14
Survey response — 3 months, dose 2MedDRA: Neuralgia, Rash — Feeling: Good · Be unable to do your normal daily activitiesFree text: Bizarre rash on leg 3 weeks ago that lasted 2 weeks. Neuropathic pain 10:10 initially thought to be shingles Biopsy showed moderate eosinophilia without virus, bacteria, or fungus. Then 3 weeks later my daughter who had same vaccinehas similar rashMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-14
Survey response — 6 months, dose 2MedDRA: Eosinophil count increased, Erythema, Facial pain, Headache, Neuralgia, Office visit, Paraesthesia, Pruritus, Pustule, Rash — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: rash (not varicella biopsy) at approx week 6,12,17 s/p 2nd Erythema, pustules, non pustules. severe pruritis, neuro pain. Crossed midline Eos up blood and bx. 5mo facial pain, headache, no rash. Parathesia of face, side of head and scalp · Healthcare visit (other): Pcp & dermatologyMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-14
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 pr1 call case(s)
- 2021-08-22
-
2022-02-12
Survey response — 12 months, dose 2MedDRA: Iron deficiency anaemia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Iron deficiency anemiaMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 8 — 3 months, dose 2
Symptoms: Bizarre rash on leg 3 weeks ago that lasted 2 weeks. Neuropathic pain 10:10 initially thought to be shingles Biopsy showed moderate eosinophilia without virus, bacteria, or fungus. Then 3 weeks later my daughter who had same vaccinehas similar rash cut off by CDC
Release 9 — 6 months, dose 2
Symptoms: rash (not varicella biopsy) at approx week 6,12,17 s/p 2nd Erythema, pustules, non pustules. severe pruritis, neuro pain. Crossed midline Eos up blood and bx. 5mo facial pain, headache, no rash. Parathesia of face, side of head and scalp
Healthcare visit (other): Pcp & dermatology
Release 11 — 12 months, dose 2
Symptoms: Iron deficiency anemia
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 | Eosinophil count increased | ✓ | · | ✓ |
| SD | Erythema | ✓ | · | ✓ |
| SD | Facial pain | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Iron deficiency anaemia | · | · | ✓ |
| SD | Neuralgia | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | · | ✓ |
| SD | Pruritus | ✓ | · | ✓ |
| SD | Pustule | ✓ | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release