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Y29-31615-93928

2 vaccinations 4 coded responses 8 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
840 / UT
Registered
2021-03-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-06
    Dose 1 — Moderna
  2. 2021-03-06
    Dose 2 — Moderna
  3. 2021-03-21
    Registered in v-safe
  4. 2021-03-21
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  5. 2021-03-28
    Survey response — day 21, dose 2
    MedDRA: Cough, Nasal congestion, Pain, Pyrexia, Rash, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Fever, chest and nasal congestion, body aches, mild cough, and still have small rash on left arm and trunk of body from after vaccination.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-04-10
    Survey response — day 35, dose 2
    MedDRA: Rash, Rash erythematous — Feeling: Fair
    Free text: I keep developing a splotchy rash that fades, and then flares up on my left arm and chest area since the vaccine. It just never fully goes away and this morning flared up quite a bit with visible quarter size red patches and some bumps.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-17
    Survey response — day 42, dose 2
    MedDRA: Blepharospasm, Injection site reaction, Rash, Rash macular, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: I have had a left eye spasm that closes my eyelid several times a day. This is a strange thing Ive never had before the last few weeks but coincides with splotchy rash that comes & goes from the injection site on my left arm and across my chest. · Healthcare visit (other): Have appointment scheduled for this week
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-17
    Report sent to call center — day 42, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-06-05
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-09-04
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  12. 2022-03-07
    Survey response — 12 months, dose 2
    MedDRA: Malaise, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: I was I'll from Dec 26-Jan 31st with Covid like symptoms, however I tested 4 different times and was negative even though my husband tested positive with the same symptoms.
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-03-07
    Report sent to call center — 12 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  14. 2022-03-11

Vaccinations

DoseDateManufacturerCo-administered
12021-02-06Moderna
22021-03-06Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-04-17 Unsuccessful
2022-03-07 Unsuccessful

Free text

Release 6 — day 21, dose 2

2021-03-28

Symptoms: Fever, chest and nasal congestion, body aches, mild cough, and still have small rash on left arm and trunk of body from after vaccination.

Release 7 — day 35, dose 2

2021-04-10

Symptoms: I keep developing a splotchy rash that fades, and then flares up on my left arm and chest area since the vaccine. It just never fully goes away and this morning flared up quite a bit with visible quarter size red patches and some bumps.

Release 7 — day 42, dose 2

2021-04-17

Symptoms: I have had a left eye spasm that closes my eyelid several times a day. This is a strange thing Ive never had before the last few weeks but coincides with splotchy rash that comes & goes from the injection site on my left arm and across my chest.
Healthcare visit (other): Have appointment scheduled for this week

Release 11 — 12 months, dose 2

2022-03-07

Symptoms: I was I'll from Dec 26-Jan 31st with Covid like symptoms, however I tested 4 different times and was negative even though my husband tested positive with the same symptoms.

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDBlepharospasm ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDInjection site reaction ✓ ✓ ✓
SDMalaise · · ✓
SDNasal congestion ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDRash erythematous ✓ ✓ ✓
SDRash macular ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release