LEQ-26612-15387
5 vaccinations
2 coded responses
50 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 223 / VA
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
QCH-20017-97124
Child or adolescent in my care · Female · 2022-06-21
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Moderna
-
2021-03-16
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-22
- 2021-03-23
- 2021-04-13
-
2021-04-15
Dose 2 — Moderna
- 2021-04-18
- 2021-07-16
- 2021-10-15
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-31
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-02
- 2021-11-03
- 2021-11-04
-
2021-11-11
Survey response — day 14, dose 3MedDRA: Rash, Rash pruritic, Urticaria — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Over the course of the past few days, I've developed hives and rashes on my scalp, hands, forearms, and midsection. They are incredibly itchy and painful. My diet has not changed, nor has my laundry detergent or soap.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-11
Report sent to call center — day 14, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2021-11-12
Call successfulCompleted over the phone
-
2021-11-18
Survey response — day 21, dose 3MedDRA: Rash, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree text: My hives and rashes have worsened over the past week. They are predominantly on my hands, arms, and neck, and stomach.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
- 2022-04-28
-
2022-05-16
Dose 4 — Pfizer-BioNTech
- 2022-05-16
-
2022-05-17
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-05-18
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-05-19
- 2022-05-20
- 2022-05-22
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-06-13
- 2022-06-20
- 2022-06-29
- 2022-08-17
-
2022-09-23
Dose 5 — Pfizer-BioNTech
-
2022-09-24
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-26
- 2022-09-29
- 2022-10-02
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-12-23
- 2023-03-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-15 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-05-16 | Pfizer-BioNTech | No |
| 5 | 2022-09-23 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 10 — day 14, dose 3
Symptoms: Over the course of the past few days, I've developed hives and rashes on my scalp, hands, forearms, and midsection. They are incredibly itchy and painful. My diet has not changed, nor has my laundry detergent or soap.
Release 10 — day 21, dose 3
Symptoms: My hives and rashes have worsened over the past week. They are predominantly on my hands, arms, and neck, and stomach.
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 | Rash | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release