X7A-29579-17624
3 vaccinations
2 coded responses
27 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 982 / WA
- Registered
- 2020-12-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
Y4J-31661-61194
Child or adolescent in my care · Male · 2021-11-18
Timeline
-
2020-12-26
Registered in v-safe
-
2020-12-26
Dose 1 — Moderna
- 2020-12-26
- 2020-12-27
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
-
2021-01-09
Survey response — day 14, dose 1MedDRA: Axillary pain, Injection site pruritus, Injection site urticaria, Pain, Rash — Feeling: GoodFree text: I got hives and itching at the injection site and soreness in my armpit on that arm. The rash and soreness developed 8 days after receiving the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-16
Survey response — day 21, dose 1MedDRA: Rash, Rash erythematous, Rash papular, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Red raised rash on chest and back · Healthcare visit (other): Appt to see dermatologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-16
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-19
Dose 2 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-02-02
- 2021-02-16
- 2021-03-02
- 2021-03-16
- 2021-07-20
-
2021-11-12
Dose 3 — Moderna
- 2021-11-12
-
2021-11-13
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-11-15
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-17
- 2021-12-24
- 2022-02-15
- 2022-05-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-26 | Moderna | |
| 2 | 2021-01-19 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-16 | Unsuccessful |
Free text
Release 1 — day 14, dose 1
Symptoms: I got hives and itching at the injection site and soreness in my armpit on that arm. The rash and soreness developed 8 days after receiving the vaccine
Release 2 — day 21, dose 1
Symptoms: Red raised rash on chest and back
Healthcare visit (other): Appt to see dermatologist
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Axillary pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site urticaria | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Rash papular | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release