6ML-33704-30102
3 vaccinations
4 coded responses
6 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 26-30
- ZIP prefix
- 112 / NY
- Registered
- 2021-12-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-01
Dose 1 — Pfizer-BioNTech
-
2021-04-22
Dose 2 — Pfizer-BioNTech
-
2021-12-03
Dose 3 — Moderna
-
2021-12-04
Registered in v-safe
-
2021-12-04
Survey response — days 1–6 daily, dose 3MedDRA: Pruritus, Urticaria — Feeling: Poor · Site: Pain · Rash, not including the immediate area around the injection siteFree text: Hives and itching all over bodyMedDRA releases: 2024-11 · check-in free text available
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2021-12-06
Survey response — days 1–6 daily, dose 3MedDRA: Discomfort, Pre-existing disease, Rash, Stress, Urticaria — Feeling: Poor · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Taking allergy medicine which helps but as soon as the effect passes rashes and hives start to come back on legs, torso, neck, arms very uncomfortable and stressfulMedDRA releases: 2024-11 · check-in free text available
-
2021-12-07
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: Feels like it's getting better but not sureMedDRA releases: 2024-11 · check-in free text available
-
2021-12-08
Survey response — days 1–6 daily, dose 3MedDRA: Rash, Self-medication, Telemedicine — Feeling: GoodFree text: Rash has settled down and have stopped taking Benadryl. Took a steroid that was prescribed by an MD following a telehealth appointment and am not going to take it today to see what happens.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-09
- 2021-12-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Pfizer-BioNTech | No |
| 2 | 2021-04-22 | Pfizer-BioNTech | No |
| 3 | 2021-12-03 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Hives and itching all over body
Systemic reaction (other): Taking allergy medicine which helps but as soon as the effect passes rashes and hives start to come back on legs, torso, neck, arms very uncomfortable and stressful
Systemic reaction (other): Feels like it's getting better but not sure
Systemic reaction (other): Rash has settled down and have stopped taking Benadryl. Took a steroid that was prescribed by an MD following a telehealth appointment and am not going to take it today to see what happens.
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 |
|---|---|---|---|---|
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Discomfort | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Stress | · | · | ✓ |
| SRO | Telemedicine | · | · | ✓ |
| SRO | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release