E6Z-31538-59927
2 vaccinations
2 coded responses
25 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 950 / CA
- Registered
- 2022-06-26
- Relationship
- Child or adolescent in my care
- Guardian
- D3F-33057-42364
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-26
Registered in v-safe
-
2022-07-06
Dose 1 — Moderna
- 2022-07-06
-
2022-07-07
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-07-08
- 2022-07-09
- 2022-07-10
- 2022-07-11
-
2022-07-12
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2022-07-13
Health check-in — day 7, dose 1, dependentFeeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-07-20
- 2022-07-27
-
2022-08-03
Dose 2 — Moderna
- 2022-08-03
-
2022-08-04
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Pruritus — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness, NauseaFree text: Itchy feetMedDRA releases: 2024-11 · check-in free text available
-
2022-08-05
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Fatigue or tiredness, NauseaAdult check-in
- 2022-08-06
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-19
- 2022-08-24
-
2022-08-31
Survey response — day 28, dose 2, dependentMedDRA: Eczema, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: (b)(6) developed excema or something similar in terms of a skin rash. It started around June and has continued.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-31
Report sent to call center — day 28, dose 2, dependentGet care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-09-01
Call successfulParticipant prefers to complete VAERS report online
- 2022-09-09
- 2022-09-14
- 2022-11-02
- 2023-02-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-06 | Moderna | No |
| 2 | 2022-08-03 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Itchy feet
Release 12 — day 28, dose 2, dependent
Symptoms: (b)(6) developed excema or something similar in terms of a skin rash. It started around June and has continued.
redacted (b)(6)
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 |
|---|---|---|---|---|
| SD | Eczema | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release