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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

  1. 2021-02-01
    Dose 1 — Moderna
  2. 2021-02-18
    Registered in v-safe
  3. 2021-02-18
    Survey response — day 14, dose 1
    MedDRA: Office visit, Pruritus, Rash — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free 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 14
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-18
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  5. 2021-03-04
    Survey response — day 28, dose 1
    MedDRA: 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 visit
    Free 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 shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-04
    Report sent to call center — day 28, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  7. 2021-08-06

Vaccinations

DoseDateManufacturerCo-administered
12021-02-01Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-02-18 Unsuccessful
2021-03-04 Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-18

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

2021-03-04

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

FieldPreferred term2021-092023-042024-11
SDMedical counselling ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDRash pruritic ✓ ✓ ✓

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