ZRE-39581-64452
1 vaccination
2 coded responses
2 check-ins
2 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 606 / IL
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-01
Dose 1 — Moderna
-
2021-02-18
Registered in v-safe
-
2021-02-18
Survey response — day 14, dose 1MedDRA: Office visit, Pruritus, Rash — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: on feb5 broke out in bad rash on neck arms stomach,back legs very itchy onsundayfeb 7th went to doctor he said probably reaction from vaccination gave me a steriod shot and prescribed a predisone z pack 40 40 30 30 20 20 10 10 which i finished on 14MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-04
Survey response — day 28, dose 1MedDRA: Medical counselling, Rash, Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Body rashes very itchy doctor gave steroids injection And prednisone rx 7 days rash still persists taking Benadryl and coating with calamine lotion 33 days now still have rash stomach and back doctor advised no 2nd shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-04
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-01 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-18 | Unsuccessful | |
| 2021-03-04 | Unsuccessful |
Free text
Release 4 — day 14, dose 1
Symptoms: on feb5 broke out in bad rash on neck arms stomach,back legs very itchy onsundayfeb 7th went to doctor he said probably reaction from vaccination gave me a steriod shot and prescribed a predisone z pack 40 40 30 30 20 20 10 10 which i finished on 14 cut off by CDC
Release 5 — day 28, dose 1
Symptoms: Body rashes very itchy doctor gave steroids injection And prednisone rx 7 days rash still persists taking Benadryl and coating with calamine lotion 33 days now still have rash stomach and back doctor advised no 2nd shot
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 | Medical counselling | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release