679-28541-72514

3 vaccinations 6 coded responses 32 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 800 / CO
Registered: 2021-03-04

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-02
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Rash, Rash pruritic, Rhinorrhoea, Sneezing — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Tuesday and Wednesday I had a very itchy rash around my neck, itchy scalp, runny nose and sneezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Pruritus — Feeling: Good

Free text: My neck and scalp are still itching, but less. The redness is gone but the itch remains.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Rash, Rhinorrhoea, Sneezing — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Not so much a rash as continuing itchy scalp & neck, continuing runny nose & sneezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — day 21, dose 2
MedDRA: Rash pruritic — Feeling: Good

Free text: Large rash on my right breast. Very itchy. Prescription excema cream helpful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fever · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Survey response — 6 months, dose 3
MedDRA: Impaired work ability, Influenza, Malaise, Office visit, Varicella — 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

Free text: Symptoms: I'm just getting over Flu A and my 4th round of chicken pox. I was off work for 2 weeks. The longest I have ever been out sick. · Healthcare visit (other): My primary care physician, in person, twice.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-10-29
Survey response — 12 months, dose 3
MedDRA: COVID-19, Influenza, Office visit, Stress, Varicella — 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

Free text: Symptoms: Aprll - fluA & chickenpox (4th time) May - Covid19 June - chickenpox (5th time) I was under extreme stress. (Family drama and move to Missouri.) But my doctors and allergists are saying not to take the 3rd booster. · Healthcare visit (other): Doctor office using contagion protocols.

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-10-29	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Tuesday and Wednesday I had a very itchy rash around my neck, itchy scalp, runny nose and sneezing.

2021-03-06

Systemic reaction (other): My neck and scalp are still itching, but less. The redness is gone but the itch remains.

2021-03-07

Systemic reaction (other): Not so much a rash as continuing itchy scalp & neck, continuing runny nose & sneezing.

Release 7 — day 21, dose 2

2021-04-20

Symptoms: Large rash on my right breast. Very itchy. Prescription excema cream helpful.

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: I'm just getting over Flu A and my 4th round of chicken pox. I was off work for 2 weeks. The longest I have ever been out sick.

Healthcare visit (other): My primary care physician, in person, twice.

Release 12 — 12 months, dose 3

2022-10-29

Symptoms: Aprll - fluA & chickenpox (4th time) May - Covid19 June - chickenpox (5th time) I was under extreme stress. (Family drama and move to Missouri.) But my doctors and allergists are saying not to take the 3rd booster.

Healthcare visit (other): Doctor office using contagion protocols.

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	COVID-19	·	·	✓
SD	Impaired work ability	·	·	✓
SD	Influenza	·	·	✓
SD	Malaise	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	Stress	·	·	✓
SD	Varicella	·	·	✓
SRO	Erythema	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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