Z8N-33292-92951
3 vaccinations
4 coded responses
25 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 208 / MD
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
-
2021-02-17
Survey response — day 14, dose 1MedDRA: Rash — Feeling: GoodFree text: small rash on fingers. could be unrelated to vaccine. they happen to me occasionally.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
-
2021-03-19
Survey response — day 14, dose 2MedDRA: Inflammation — Feeling: GoodFree text: minor skin inflammation on fingers (may not be related)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-04-08
- 2021-04-15
- 2021-06-02
-
2021-12-05
Dose 3 — Moderna
-
2022-03-06
Survey response — 12 months, dose 2MedDRA: Discomfort, Loss of personal independence in daily activities, Mechanical urticaria, Rash — Feeling: Poor · Be unable to work or attend schoolFree text: about 10 days after my moderna booster, I developed a systemic rash. The rash morphed into a case of dermatographic urticaria (L50.3). It causes daily discomfort and affects may day to day aspects of my life even the ability to pick up my daughter.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-08
Survey response — 6 months, dose 3MedDRA: Urticaria — 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, Outpatient clinic or urgent care clinic visitFree text: Hives (aka chronic spontaneous uricaria) from the booster in December have abated but not yet fully resolvedMedDRA releases: 2024-11 · check-in free text available
-
2022-06-08
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-09
-
2022-06-09
Callback requested for02:12PM ET
-
2022-06-09
Call successfulReported to VAERS voluntarily prior to GDIT contact
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-12-05 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-08 | Successful 2022-06-09 |
Reported to VAERS voluntarily prior to GDIT contact |
Free text
Release 4 — day 14, dose 1
Symptoms: small rash on fingers. could be unrelated to vaccine. they happen to me occasionally.
Release 5 — day 14, dose 2
Symptoms: minor skin inflammation on fingers (may not be related)
Release 11 — 12 months, dose 2
Symptoms: about 10 days after my moderna booster, I developed a systemic rash. The rash morphed into a case of dermatographic urticaria (L50.3). It causes daily discomfort and affects may day to day aspects of my life even the ability to pick up my daughter. cut off by CDC
Release 11 — 6 months, dose 3
Symptoms: Hives (aka chronic spontaneous uricaria) from the booster in December have abated but not yet fully resolved
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 | Discomfort | · | · | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Mechanical urticaria | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release