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Z63-31202-61953

4 vaccinations 11 coded responses 31 check-ins 10 free-text entries 1 call case
Sex
Female
Age at first dose
36-40
ZIP prefix
549 / WI
Registered
2021-04-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-08
    Dose 1 — Moderna
  2. 2021-04-09
    Registered in v-safe
  3. 2021-04-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches
    Free text: I have a rash all the way around my neck and on my chest.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash, Rash pruritic — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: The rash in my neck and chest is a little better, but still a little itchy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash, Rash pruritic — Feeling: Good
    Free text: I still have the rash on my neck and chest, but it doesnt itch anymore.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash — Feeling: Good
    Free text: Rash is still present but getting lighter.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pruritus, Rash — Feeling: Good
    Free text: Rash is still visible but not itchy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rash — Feeling: Good
    Free text: Rash is starting to fade away. Not itching
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-15
    Survey response — day 7, dose 1
    MedDRA: Rash — Feeling: Good · Headache
    Free text: I think the rash is gone.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-22
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-04-29
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-05-06
    Dose 2 — Moderna
  13. 2021-05-06
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  14. 2021-05-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  15. 2021-05-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Adult check-in
  16. 2021-05-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness
    Adult check-in
  17. 2021-05-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling hot — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness
    Free text: Feel really warm. Have been the whole time since the second shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-05-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-05-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-05-13
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-05-20
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-27
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-06-03
    Survey response — day 28, dose 2
    MedDRA: Erythema, Rash — Feeling: Good
    Free text: Red and rash around my neck.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-06-10
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-06-17
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-08-05
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-11-04
    Survey response — 6 months, dose 2
    MedDRA: Lung disorder, Rales — Feeling: Good
    Free text: Lungs seem wet and crackles.
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-12-22
    Dose 3 — Moderna
  29. 2022-05-06
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  30. 2022-09-20
    Dose 4 — Moderna
    Co-administered: Flu
  31. 2022-10-14
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  32. 2022-10-18
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  33. 2022-10-25
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  34. 2022-11-01
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  35. 2022-12-20
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  36. 2023-03-21
    Survey response — 6 months, dose 4
    MedDRA: Cough, Fatigue, Headache, Nasal congestion, Pain, Pyrexia, Rhinorrhoea — Feeling: Fair · 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
    MedDRA releases: 2024-11
  37. 2023-03-21
    Report sent to call center — 6 months, dose 4
    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 · 1 call case(s)
  38. 2023-03-22

Vaccinations

DoseDateManufacturerCo-administered
12021-04-08Moderna
22021-05-06Moderna
32021-12-22Moderna No
42022-09-20Moderna Flu

Call center

ReportedOutcomeVAERS-related outcome
2023-03-21 Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): I have a rash all the way around my neck and on my chest.

2021-04-10

Systemic reaction (other): The rash in my neck and chest is a little better, but still a little itchy.

2021-04-11

Systemic reaction (other): I still have the rash on my neck and chest, but it doesnt itch anymore.

2021-04-12

Systemic reaction (other): Rash is still present but getting lighter.

2021-04-13

Systemic reaction (other): Rash is still visible but not itchy

2021-04-14

Systemic reaction (other): Rash is starting to fade away. Not itching

Release 7 — day 7, dose 1

2021-04-15

Systemic reaction (other): I think the rash is gone.

Release 8 — days 1–6 daily, dose 2

2021-05-10

Systemic reaction (other): Feel really warm. Have been the whole time since the second shot.

Release 8 — day 28, dose 2

2021-06-03

Symptoms: Red and rash around my neck.

Release 10 — 6 months, dose 2

2021-11-04

Symptoms: Lungs seem wet and crackles.

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
SDCough · · ✓
SDErythema ✓ ✓ ✓
SDFatigue · · ✓
SDHeadache · · ✓
SDLung disorder · · ✓
SDNasal congestion · · ✓
SDPain · · ✓
SDPyrexia · · ✓
SDRales · · ✓
SDRash ✓ ✓ ✓
SDRhinorrhoea · · ✓
SROFeeling hot ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SRORash ✓ ✓ ✓
SRORash pruritic ✓ ✓ ✓

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

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