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ZHY-19580-17736

2 vaccinations 4 coded responses 10 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
148 / NY
Registered
2021-02-06
Relationship
Self
Race
White
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-02-06
    Registered in v-safe
  2. 2021-02-06
    Dose 1 — Moderna
  3. 2021-02-16
    Survey response — day 7, dose 1
    MedDRA: Immunisation reaction, Pruritus, Rash macular — Feeling: Poor · Site: Redness, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: COVID Arm began on Day 8. Today is day 10. Arm is itchy. Blotches of red going down the arm 3-5 below vaccination spot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-20
    Survey response — day 14, dose 1
    MedDRA: Injection site rash, Injection site swelling, Office visit, Pruritus, Rash — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: First Moderna vaccine was on 2/8/2021. On 2/14 I got a rash and swelling by the shot. The area by the shot is better but the rash has extended down my arm to the shoulder joint and under my arm. Its fading but discolored and itchy. My doctor know · Healthcare visit (other): Doctor has spoken to me twice. Dr has seen pictures. Wish I could send you a picture. Will go for 2nd shot but afraid of a worse reaction.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-20
    Report sent to call center — day 14, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-02-27
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-03-06
    Dose 2 — Moderna
  8. 2021-03-06
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  9. 2021-03-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Medical counselling — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: I called my doctor.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-07
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  11. 2021-03-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  12. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness · Fever · Chills, Joint pains, Fatigue or tiredness
    Adult check-in
  13. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness · Headache, Fatigue or tiredness
    Adult check-in
  14. 2021-03-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Urticaria — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site
    Free text: A few hives on my chest and back during the night. All gone now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-08-16
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  16. 2021-09-04
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

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

Call center

ReportedOutcomeVAERS-related outcome
2021-02-20 Successful Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-07 Successful
2021-08-16
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — day 7, dose 1

2021-02-16

Systemic reaction (other): COVID Arm began on Day 8. Today is day 10. Arm is itchy. Blotches of red going down the arm 3-5 below vaccination spot.

Release 4 — day 14, dose 1

2021-02-20

Symptoms: First Moderna vaccine was on 2/8/2021. On 2/14 I got a rash and swelling by the shot. The area by the shot is better but the rash has extended down my arm to the shoulder joint and under my arm. Its fading but discolored and itchy. My doctor know
Healthcare visit (other): Doctor has spoken to me twice. Dr has seen pictures. Wish I could send you a picture. Will go for 2nd shot but afraid of a worse reaction.

Release 5 — days 1–6 daily, dose 2

2021-03-07

Healthcare visit (other): I called my doctor.

2021-03-11

Systemic reaction (other): A few hives on my chest and back during the night. All gone now.

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
HCVOMedical counselling ✓ ✓ ✓
HCVOOffice visit ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDInjection site swelling ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDRash ✓ ✓ ✓
SROImmunisation reaction ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SRORash macular ✓ ✓ ✓
SROUrticaria ✓ ✓ ✓

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