ZRV-27102-59311
4 vaccinations
14 coded responses
33 check-ins
14 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 786 / TX
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-24
Dose 1 — Moderna
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2021-03-10
Registered in v-safe
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2021-03-10
Survey response — day 14, dose 1MedDRA: Rash — Feeling: FairFree text: My skin was reacting as though I had lots of contact allergies. It was mostly on my arm(s). It is no liner happenibg, but occured for 7- 19 days I can't help but wonder if it was a reaction to the vaccine.It varied in how it looked.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — day 21, dose 1MedDRA: Skin reaction — Feeling: GoodFree text: Not new, but returning skin reactions....kind of like a contact allergyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Dose 2 — Moderna
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2021-03-24
Survey response — day 28, dose 1MedDRA: Skin reaction — Feeling: FairFree text: Not really new, but skin reactions continue to occurMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Health check-in — day 7, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
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2021-04-07
Survey response — day 14, dose 2MedDRA: Pruritus, Rash, Swelling — Feeling: GoodFree text: Not new, but rash keeps appearing/ disappearing. This week I kneeled on the grass/weeds in short leggings . Both calves broke out; it really bothered me with itching. I experienced, for the first time, rash on upper chest, w/slight swelling i spotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Survey response — day 21, dose 2MedDRA: Hypersensitivity, Office visit, Rash, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Rash that I have had all along ..still happening; Saw my NP, who said it is a histamine reaction. I went to rule out anything more serious . · Healthcare visit (other): In person appt.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-23
Survey response — day 28, dose 2MedDRA: Rash — Feeling: GoodFree text: Sporadic rash continues. Appeared on top of my foot for the first time ... yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — day 35, dose 2MedDRA: Rash — Feeling: FairFree text: Same reaction, rashes,but this week it appeared on the top of both of my feet This is the first time it has appeared on my feet. But made it uncomfortable to wear my shoes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
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2021-06-23
Survey response — 3 months, dose 2MedDRA: Office visit, Pre-existing disease, Rash, Specialist consultation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: My ongoing rash is worse. My NP and my Dermatologist agree that it is from the vaccines. I start a new antihistamine (one if three I am/ will be taking. I had a breast biopsy&developed a raging case if the rash in that area. I still see outline · Healthcare visit (other): 2 scheduled visits each with NP and DermatologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-23
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-25
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2021-09-24
Survey response — 6 months, dose 2MedDRA: Pre-existing disease, Rash — Feeling: FairFree text: Not new, but rash since the first immunization ( I've had two) has continued, sporadically, as in the beginning. It appears to come out anywhere something touches my skin ( has always been that way).MedDRA releases: 2024-11 · check-in free text available
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2021-10-17
Dose 3 — Moderna
- 2021-10-28
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2021-10-31
Survey response — day 14, dose 3MedDRA: Pre-existing disease, Rash — Feeling: GoodFree text: Not new, still more occasional rashMedDRA releases: 2024-11 · check-in free text available
- 2021-11-07
- 2021-11-14
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2021-11-21
Survey response — day 35, dose 3MedDRA: Rash — Feeling: GoodFree text: Not new, but have had third vaccination and still have the rashMedDRA releases: 2024-11 · check-in free text available
- 2021-11-28
- 2022-01-16
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2022-04-15
Dose 4 — Moderna
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2022-04-15
Health check-in — day 0, dose 4Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-04-16
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2022-04-17
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue — Feeling: GoodFree text: Tiredness _ for 2nd dayMedDRA releases: 2024-11 · check-in free text available
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2022-04-18
Health check-in — days 1–6 daily, dose 4Feeling: Good · Headache, Fatigue or tirednessAdult check-in
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2022-04-19
Survey response — days 1–6 daily, dose 4MedDRA: Rash — Feeling: GoodFree text: Rash, which I have since 1st injection of the 4, still appearsMedDRA releases: 2024-11 · check-in free text available
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2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
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2022-04-22
Health check-in — day 7, dose 4Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-04-30
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
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2022-07-15
Survey response — 3 months, dose 4MedDRA: Hypersensitivity, Pre-existing disease, Rash — Feeling: GoodFree text: Nor really new, but vaccine rash, for which I have been prescribed as n additional allergy pill, seems to be occuring with more frequently than previously.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-14
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-24 | Moderna | |
| 2 | 2021-03-24 | Moderna | |
| 3 | 2021-10-17 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-14 | Unsuccessful | |
| 2021-06-23 | Unsuccessful |
Free text
Release 5 — day 14, dose 1
Symptoms: My skin was reacting as though I had lots of contact allergies. It was mostly on my arm(s). It is no liner happenibg, but occured for 7- 19 days I can't help but wonder if it was a reaction to the vaccine.It varied in how it looked.
Release 5 — day 21, dose 1
Symptoms: Not new, but returning skin reactions....kind of like a contact allergy
Release 6 — day 28, dose 1
Symptoms: Not really new, but skin reactions continue to occur
Release 7 — day 14, dose 2
Symptoms: Not new, but rash keeps appearing/ disappearing. This week I kneeled on the grass/weeds in short leggings . Both calves broke out; it really bothered me with itching. I experienced, for the first time, rash on upper chest, w/slight swelling i spot cut off by CDC
Release 7 — day 21, dose 2
Symptoms: Rash that I have had all along ..still happening; Saw my NP, who said it is a histamine reaction. I went to rule out anything more serious .
Healthcare visit (other): In person appt.
Release 7 — day 28, dose 2
Symptoms: Sporadic rash continues. Appeared on top of my foot for the first time ... yesterday
Release 8 — day 35, dose 2
Symptoms: Same reaction, rashes,but this week it appeared on the top of both of my feet This is the first time it has appeared on my feet. But made it uncomfortable to wear my shoes.
Release 9 — 3 months, dose 2
Symptoms: My ongoing rash is worse. My NP and my Dermatologist agree that it is from the vaccines. I start a new antihistamine (one if three I am/ will be taking. I had a breast biopsy&developed a raging case if the rash in that area. I still see outline cut off by CDC
Healthcare visit (other): 2 scheduled visits each with NP and Dermatologist
Release 9 — 6 months, dose 2
Symptoms: Not new, but rash since the first immunization ( I've had two) has continued, sporadically, as in the beginning. It appears to come out anywhere something touches my skin ( has always been that way).
Release 10 — day 14, dose 3
Symptoms: Not new, still more occasional rash
Release 10 — day 35, dose 3
Symptoms: Not new, but have had third vaccination and still have the rash
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Tiredness _ for 2nd day
Systemic reaction (other): Rash, which I have since 1st injection of the 4, still appears
Release 12 — 3 months, dose 4
Symptoms: Nor really new, but vaccine rash, for which I have been prescribed as n additional allergy pill, seems to be occuring with more frequently than previously.
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 | ✓ | ✓ | ✓ |
| HCVO | Specialist consultation | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ○ | ✓ | ○ |
| SD | Histamine intolerance | ○ | · | ○ |
| SD | Hypersensitivity | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Skin reaction | ✓ | ✓ | ✓ |
| SD | Swelling | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release