UTE-83744-60953
1 vaccination
1 coded response
1 check-in
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 900 / CA
- Registered
- 2021-05-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-18
Dose 1 — Moderna
-
2021-05-29
Registered in v-safe
-
2021-05-29
Survey response — day 7, dose 1MedDRA: Herpes zoster — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Shingles outbreakMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-29
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-18 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-29 | Unsuccessful |
Free text
Release 8 — day 7, dose 1
Systemic reaction (other): Shingles outbreak
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 | Herpes zoster | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release