6AZ-15689-35138

5 vaccinations 20 coded responses 47 check-ins 20 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 957 / CA
Registered: 2021-05-10

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

2021-04-08
Dose 1 — Moderna
2021-05-06
Dose 2 — Moderna
2021-05-10
Registered in v-safe
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Pre-existing disease, Rash, Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: I'm prone to eczema and had active areas before being vaccinated. After the second dose, I experienced a noticeable increase in rash. At times, the new rash is quite itchy. Rash is mostly on back and legs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Medical counselling, Rash, Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: The rash as reported yesterday continued today. The rash was very itchy last night and at times today. I exchanged messages with my dermatologist today, and he directed me to apply triamcinolone 0.1% cream to the affected areas. Before receiving dose 2, there were some areas of eczema present. The rash Im experiencing and reporting is in addition to the eczema and represents more than doubling the amount of rash that was present prior to receiving dose 2.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Still have itchy rash. Itching slightly less than yesterday. Continuing to apply triamcinolone cream on the rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-05-20
Survey response — day 14, dose 2
MedDRA: Pruritus, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Still have rash/eczema after dose 2. Sometimes, very itchy. Some previous rash is subsiding. Some new small rash has appeared. In an exchange of messages, dermatologist says he has heard of some increased eczema symptoms post vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-29
Survey response — day 21, dose 2
MedDRA: Eczema, Rash, Self-medication — Feeling: Good

Free text: Continuing rash/eczema.The widespread rash which occurred after dose #2, three weeks ago, has subsided significantly. Still experiencing new, less intense rash every couple of days. New rash area is smaller. Continuing to apply triamcinolone cream.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-20
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Eczema, Pre-existing disease, Pruritus — Feeling: Good

Free text: My eczema/atopic dermatitis has flared-up noticeably over the last few days, and is quite itchy. Not sure if this relates to the vaccine, but thought I would report this in case its relevant.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-06
Health check-in — 6 months, dose 2
Feeling: Good

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

Adult check-in
2021-11-12
Survey response — days 1–6 daily, dose 3
MedDRA: Irritability, Pruritus, Rash — Feeling: Good · Rash, not including the immediate area around the injection site · Be unable to work or attend school

Free text: Notes regarding rash: Location is on both legs, some on back and other places. Itchy and annoying, treating with Triamcinolone. Rate symptoms between mild to moderate.

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: I rated the rash as Moderate because applying Triamcinolone to the rash takes time which interferes with other activities. The rash is not getting worse.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-17
Survey response — day 7, dose 3
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash is subsiding.

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-02
Survey response — day 21, dose 3
MedDRA: Rash pruritic — Feeling: Good

Free text: Tried to report this last week: Appx 10 days ago, the itchy rash (which had been subsiding) flared up somewhat. Currently, rash is subsiding again. This is similar to what happened following the 2nd dose. Some of the rash is on areas prone to eczema.

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — day 28, dose 3
MedDRA: Eczema, Rash, Rash pruritic — Feeling: Good

Free text: New rash on back, top of arms, legs. This started appx five days ago, and is itchy. Not sure if this is vaccine related or eczema. Have been applying Triamcinolone cream. Applying the cream is time consuming. I would rate the rash as moderate.

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-27
Dose 4 — Moderna
2022-04-27
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-30
Survey response — days 1–6 daily, dose 4
MedDRA: Eczema — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Free text: Eczema is slightly worse today than yesterday.

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — days 1–6 daily, dose 4
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Previously reported rash is beginning to subside.

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Survey response — days 1–6 daily, dose 4
MedDRA: Eczema, Pre-existing disease, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Skin rash is continuing subside and is approaching my typical eczema levels.

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-06
Health check-in — day 7, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-12
Call 1 — Left Voicemail
2022-05-12
Call successful
Participant prefers to complete VAERS report online
2022-05-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-01
Survey response — day 35, dose 4
MedDRA: Eczema, Pre-existing disease — Feeling: Good

Free text: Eczema has flared up noticeably. I don't know if this is vaccine related, but thought I would report it.

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-28
Dose 5 — Moderna
2022-09-29
Survey response — days 1–6 daily, dose 5
MedDRA: Eczema, Pre-existing disease, Rash, Reaction to previous exposure to any vaccine — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: The rash experienced is similar to dose#2. It appears to be a significant flareup of eczema. It's located on various places my back, one side of torso (not continuous), and multiple areas on both legs.

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Survey response — days 1–6 daily, dose 5
MedDRA: Discomfort, Rash, Rash pruritic — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Continued rash and some new rash on the last 24 hours. The rash can be very itchy and uncomfortable. The rash is located on my back, upper arms, legs, some on abdomen.

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Survey response — days 1–6 daily, dose 5
MedDRA: Rash, Rash papular, Rash pruritic, Sleep disorder — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Itchy post-vaccine rash continues. It's located mostly my back, upper arms, and legs. At times, the itching can be intense, and has interrupted my sleep a few nights. Some of the rash is raised. Vaccine info: Moderna Bivalent, lot#(b)(6)

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Survey response — days 1–6 daily, dose 5
MedDRA: Pruritus, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Continuing rash. Some of the rash is beginning to calm down somewhat. Rash located on back, upper arms, legs, some on abdomen and waist. Have occasional flareups of intense itching. Have been applying triamcinolone cream.

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Survey response — day 7, dose 5
MedDRA: Discomfort, Eczema, Immunisation reaction, Office visit, Pruritus, Rash — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Continued rash. Some lessening of rash. Still experiencing uncomfortable itching at times. Visited my dermatologist; he said the symptoms are consistent with post vaccine rash and eczema may be contributing. Continuing triamcinolone cream on rash. · Healthcare visit (other): Visited my Dermatologist office.

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — day 7, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-06
Call successful
Participant prefers to complete VAERS report online
2022-10-13
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-31
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-31
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna
2	2021-05-06	Moderna
3	2021-11-10	Moderna	No
4	2022-04-27	Moderna	No
5	2022-09-28	Moderna	No

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-10

Systemic reaction (other): I'm prone to eczema and had active areas before being vaccinated. After the second dose, I experienced a noticeable increase in rash. At times, the new rash is quite itchy. Rash is mostly on back and legs.

2021-05-11

Systemic reaction (other): The rash as reported yesterday continued today. The rash was very itchy last night and at times today. I exchanged messages with my dermatologist today, and he directed me to apply triamcinolone 0.1% cream to the affected areas. Before receiving dose 2, there were some areas of eczema present. The rash Im experiencing and reporting is in addition to the eczema and represents more than doubling the amount of rash that was present prior to receiving dose 2.

2021-05-12

Systemic reaction (other): Still have itchy rash. Itching slightly less than yesterday. Continuing to apply triamcinolone cream on the rash.

Release 8 — day 14, dose 2

2021-05-20

Symptoms: Still have rash/eczema after dose 2. Sometimes, very itchy. Some previous rash is subsiding. Some new small rash has appeared. In an exchange of messages, dermatologist says he has heard of some increased eczema symptoms post vaccination.

Release 8 — day 21, dose 2

2021-05-29

Symptoms: Continuing rash/eczema.The widespread rash which occurred after dose #2, three weeks ago, has subsided significantly. Still experiencing new, less intense rash every couple of days. New rash area is smaller. Continuing to apply triamcinolone cream. cut off by CDC

Release 9 — day 42, dose 2

2021-06-20

Symptoms: My eczema/atopic dermatitis has flared-up noticeably over the last few days, and is quite itchy. Not sure if this relates to the vaccine, but thought I would report this in case its relevant.

Release 10 — days 1–6 daily, dose 3

2021-11-12

Systemic reaction (other): Notes regarding rash: Location is on both legs, some on back and other places. Itchy and annoying, treating with Triamcinolone. Rate symptoms between mild to moderate.

2021-11-14

Systemic reaction (other): I rated the rash as Moderate because applying Triamcinolone to the rash takes time which interferes with other activities. The rash is not getting worse.

Release 10 — day 7, dose 3

2021-11-17

Systemic reaction (other): Rash is subsiding.

Release 10 — day 21, dose 3

2021-12-02

Symptoms: Tried to report this last week: Appx 10 days ago, the itchy rash (which had been subsiding) flared up somewhat. Currently, rash is subsiding again. This is similar to what happened following the 2nd dose. Some of the rash is on areas prone to eczema. cut off by CDC

Release 10 — day 28, dose 3

2021-12-11

Symptoms: New rash on back, top of arms, legs. This started appx five days ago, and is itchy. Not sure if this is vaccine related or eczema. Have been applying Triamcinolone cream. Applying the cream is time consuming. I would rate the rash as moderate.

Release 11 — days 1–6 daily, dose 4

2022-04-30

Systemic reaction (other): Eczema is slightly worse today than yesterday.

2022-05-01

Systemic reaction (other): Previously reported rash is beginning to subside.

2022-05-02

Systemic reaction (other): Skin rash is continuing subside and is approaching my typical eczema levels.

Release 11 — day 35, dose 4

2022-06-01

Symptoms: Eczema has flared up noticeably. I don't know if this is vaccine related, but thought I would report it.

Release 12 — days 1–6 daily, dose 5

2022-09-29

Systemic reaction (other): The rash experienced is similar to dose#2. It appears to be a significant flareup of eczema. It's located on various places my back, one side of torso (not continuous), and multiple areas on both legs.

2022-10-01

Systemic reaction (other): Continued rash and some new rash on the last 24 hours. The rash can be very itchy and uncomfortable. The rash is located on my back, upper arms, legs, some on abdomen.

2022-10-03

Systemic reaction (other): Itchy post-vaccine rash continues. It's located mostly my back, upper arms, and legs. At times, the itching can be intense, and has interrupted my sleep a few nights. Some of the rash is raised. Vaccine info: Moderna Bivalent, lot#(b)(6)

redacted (b)(6)

2022-10-04

Systemic reaction (other): Continuing rash. Some of the rash is beginning to calm down somewhat. Rash located on back, upper arms, legs, some on abdomen and waist. Have occasional flareups of intense itching. Have been applying triamcinolone cream.

Release 12 — day 7, dose 5

2022-10-05

Systemic reaction (other): Continued rash. Some lessening of rash. Still experiencing uncomfortable itching at times. Visited my dermatologist; he said the symptoms are consistent with post vaccine rash and eczema may be contributing. Continuing triamcinolone cream on rash.

Healthcare visit (other): Visited my Dermatologist 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	Condition aggravated	✓	✓	✓
SD	Eczema	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	·	·	✓
SD	Self-medication	✓	✓	✓
SRO	Discomfort	·	·	✓
SRO	Eczema	✓	✓	✓
SRO	Immunisation reaction	·	·	✓
SRO	Irritability	·	·	✓
SRO	Medical counselling	✓	✓	✓
SRO	Office visit	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Rash	✓	✓	✓
SRO	Rash papular	·	·	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Sleep disorder	·	·	✓

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