Z9K-23353-37595
5 vaccinations
4 coded responses
67 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 992 / WA
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
-
2021-02-06
Survey response — day 14, dose 1MedDRA: Rash, Rash pruritic, Skin irritation — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I got my shot on Saturday 1/23/21, and on Sunday evening 01/31/21, I broke out in a rash from my upper arms trough my thighs just above my knees. This area also included my lower back and buttocks. It included intense itiching and irritation .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-13
Survey response — day 21, dose 1MedDRA: Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Rash on torso one week after 1st vaccination. It's gradually going away. Got a cream prescription from the dermatologist. · Healthcare visit (other): DermatologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-20
-
2021-02-24
Dose 2 — Moderna
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
-
2021-04-07
Survey response — day 42, dose 2MedDRA: Rash — Feeling: GoodFree text: I have a rash on my left leg in the ankle area that runs about 3 inches above the left leg. I have never had any rashes until I received this vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Survey response — 3 months, dose 2MedDRA: Chronic pigmented purpura, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Don't know if it's related, but I now have Shamberg' in my lower left leg. I 've never had it before. · Healthcare visit (other): DermatologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-14
- 2021-08-25
-
2021-10-26
Dose 3 — Moderna
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-01-25
-
2022-04-15
Dose 4 — Moderna
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-07-15
-
2022-10-10
Dose 5 — ModernaCo-administered: Flu
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-13
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-26
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2022-11-21
- 2023-01-09
- 2023-04-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
| 5 | 2022-10-10 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-06 | Unsuccessful | |
| 2021-02-13 | Unsuccessful | |
| 2021-05-26 | Unsuccessful |
Free text
Release 3 — day 14, dose 1
Symptoms: I got my shot on Saturday 1/23/21, and on Sunday evening 01/31/21, I broke out in a rash from my upper arms trough my thighs just above my knees. This area also included my lower back and buttocks. It included intense itiching and irritation .
Release 4 — day 21, dose 1
Symptoms: Rash on torso one week after 1st vaccination. It's gradually going away. Got a cream prescription from the dermatologist.
Healthcare visit (other): Dermatologist
Release 7 — day 42, dose 2
Symptoms: I have a rash on my left leg in the ankle area that runs about 3 inches above the left leg. I have never had any rashes until I received this vaccine.
Release 8 — 3 months, dose 2
Symptoms: Don't know if it's related, but I now have Shamberg' in my lower left leg. I 've never had it before.
Healthcare visit (other): 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 | Office visit | ✓ | ✓ | ✓ |
| SD | Chronic pigmented purpura | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Skin irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release