6WB-19376-07526
4 vaccinations
3 coded responses
32 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 802 / CO
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Dose 1 — Moderna
-
2021-03-24
Registered in v-safe
- 2021-03-24
- 2021-03-25
- 2021-04-01
- 2021-04-08
-
2021-04-15
Dose 2 — Moderna
- 2021-04-15
-
2021-04-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-17
-
2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-20
- 2021-04-21
-
2021-04-22
Survey response — day 7, dose 2MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tirednessFree text: I developed a chalazion on 04/20. No idea if its related.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-07-15
- 2021-10-14
-
2021-11-15
Dose 3 — Moderna
- 2022-04-15
- 2022-05-16
-
2022-08-03
Dose 4 — Moderna
- 2022-08-05
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-19
-
2022-08-24
Survey response — day 21, dose 4MedDRA: Office visit, Rash, Rash pruritic — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Itchy rash on arms where exposed to sun-started early August. · Healthcare visit (other): Regular visit with primary care; upcoming appointment with allergistMedDRA releases: 2024-11 · check-in free text available
-
2022-08-24
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-08-25
- 2022-09-02
-
2022-09-09
Survey response — day 35, dose 4MedDRA: Adverse drug reaction, Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Continuing rash on arms, worsening since no longer using steroid cream. Diagnosed as a photosynthetic reaction to a chemical in sunscreen (testing in Nov.). Started within a week of 2nd booster but that might not have caused the rash. · Healthcare visit (other): On person visit with allergistMedDRA releases: 2024-11 · check-in free text available
-
2022-09-09
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-09-13
- 2022-09-13
- 2022-09-16
-
2022-09-23
Call successfulDoes not wish to fill out VAERS report
-
2022-09-23
Call successfulDoes not wish to fill out VAERS report
- 2022-11-04
- 2023-02-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-15 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-08-03 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 7 — day 7, dose 2
Systemic reaction (other): I developed a chalazion on 04/20. No idea if its related.
Release 12 — day 21, dose 4
Symptoms: Itchy rash on arms where exposed to sun-started early August.
Healthcare visit (other): Regular visit with primary care; upcoming appointment with allergist
Release 12 — day 35, dose 4
Symptoms: Continuing rash on arms, worsening since no longer using steroid cream. Diagnosed as a photosynthetic reaction to a chemical in sunscreen (testing in Nov.). Started within a week of 2nd booster but that might not have caused the rash.
Healthcare visit (other): On person visit with allergist
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 | Adverse drug reaction | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release