69M-21930-45201

2 vaccinations 9 coded responses 11 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 908 / CA
Registered: 2021-03-20

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-16
Dose 1 — Moderna
2021-03-16
Dose 2 — Moderna
2021-03-20
Registered in v-safe
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Itching on scalp, under arms, and top of pubic area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Fatigue or tiredness

Free text: All day Itchy scalp, itchy armpits, and in the evening additional itchy hand palms and pubic area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 7, dose 2
MedDRA: Pruritus — Feeling: Poor · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: ITCHING all day and through the night in the same places,at pits, scalp, pubic area. and both hand palms.; BUT now including entire back and upper shouldars.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 14, dose 2
MedDRA: Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: The itching on my scalp, below my under arms, upper shoulders AND has now expanded to include my entire back, hips, upper side of legs nearest the hips, and sides of my breasts. I began with itching only at night BUT now it is all day, consequently,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 21, dose 2
MedDRA: Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: The itching has increased it no longer allows me to sleep. It remind me of the Eczema I suffered 15 years ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 28, dose 2
MedDRA: Insomnia, Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Entire body itch. Worse at night, so I havent slept in almost 3 weeks.COULD I BE ALLERGIC TO THE MODERNA VACCINE? It no longer seems to be MORE just a reaction Its been 6 weeks of itching that has gotten WORSE!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-04-29
Survey response — day 42, dose 2
MedDRA: Insomnia, Office visit, Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Worse itching, definitely not diminishing. Cant sleep at all · Healthcare visit (other): Office Visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Survey response — 3 months, dose 2
MedDRA: Burning sensation, Hypersensitivity, Insomnia, Office visit, Pruritus, Sensitive skin, Skin burning sensation — Feeling: Poor · 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: My hypersensitivity reaction now includes, besides entire body agonizing itching and sleeplessness (because of the itching) I NOW also experience my super sensitive skin burning feeling as if my skin was on fire. · Healthcare visit (other): Dermatologist appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — 3 months, dose 2
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)
2021-06-17
Call 1 — Could Not Reach Participant
2021-06-22
Call 2 — Left Voicemail
2021-09-14
Survey response — 6 months, dose 2
MedDRA: Burning sensation, Hypersensitivity, Office visit, Pruritus — Feeling: Poor · 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: Besides allergic reaction to the Moderna vaccine body itching throughout my body from the scalp to the bottoms of my feet, not my face, also have a burning reaction · Healthcare visit (other): In office visits since April 2021

MedDRA releases: 2024-11 · check-in free text available
2021-09-14
Report sent to call center — 6 months, dose 2
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)
2021-09-16
Call 1 — Left Voicemail
2022-03-16
Health check-in — 12 months, dose 2
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Moderna
2	2021-03-16	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Itching on scalp, under arms, and top of pubic area.

2021-03-21

Systemic reaction (other): All day Itchy scalp, itchy armpits, and in the evening additional itchy hand palms and pubic area

Release 6 — day 7, dose 2

2021-03-23

Systemic reaction (other): ITCHING all day and through the night in the same places,at pits, scalp, pubic area. and both hand palms.; BUT now including entire back and upper shouldars.

Release 6 — day 14, dose 2

2021-03-30

Symptoms: The itching on my scalp, below my under arms, upper shoulders AND has now expanded to include my entire back, hips, upper side of legs nearest the hips, and sides of my breasts. I began with itching only at night BUT now it is all day, consequently, cut off by CDC

Release 7 — day 21, dose 2

2021-04-06

Symptoms: The itching has increased it no longer allows me to sleep. It remind me of the Eczema I suffered 15 years ago.

Release 7 — day 28, dose 2

2021-04-18

Symptoms: Entire body itch. Worse at night, so I havent slept in almost 3 weeks.COULD I BE ALLERGIC TO THE MODERNA VACCINE? It no longer seems to be MORE just a reaction Its been 6 weeks of itching that has gotten WORSE!

Release 8 — day 42, dose 2

2021-04-29

Symptoms: Worse itching, definitely not diminishing. Cant sleep at all

Healthcare visit (other): Office Visit

Release 9 — 3 months, dose 2

2021-06-15

Symptoms: My hypersensitivity reaction now includes, besides entire body agonizing itching and sleeplessness (because of the itching) I NOW also experience my super sensitive skin burning feeling as if my skin was on fire.

Healthcare visit (other): Dermatologist appointment

Release 9 — 6 months, dose 2

2021-09-14

Symptoms: Besides allergic reaction to the Moderna vaccine body itching throughout my body from the scalp to the bottoms of my feet, not my face, also have a burning reaction

Healthcare visit (other): In office visits since April 2021

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	Burning sensation	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Sensitive skin	✓	✓	✓
SD	Skin burning sensation	·	·	✓
SRO	Pruritus	✓	✓	✓

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