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ZSE-24623-55005

1 vaccination 4 coded responses 14 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
981 / WA
Registered
2021-01-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-20
    Dose 1 — Moderna
  2. 2021-01-21
    Registered in v-safe
  3. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Joint pains
    Adult check-in
  4. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · None
    Adult check-in
  5. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-27
    Survey response — day 7, dose 1
    MedDRA: Urticaria — Feeling: Fair · Rash, not including the immediate area around the injection site
    Free text: Hives around my neck
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-03
    Survey response — day 14, dose 1
    MedDRA: Pruritus, Urticaria — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Hives, terrible rash that reminds me of chicken pox because it is mainly on my trunk area, though started around filler bone, itchy neck,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-03
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-02-10
    Survey response — day 21, dose 1
    MedDRA: Rash pruritic, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Moderna dose 1 took place Jan 20. On Jan 26 noticed a significant itchy rash that has continued since, first on collar bone and shoulders, then progressed to general trunk area, then arms, then scalp. · Healthcare visit (other): The nurse practitioner see at (b)(6) on Feb 1 did not think it was vaccine related and sent me home with nothing other than suggesting I push back the second dose. (I was already taking benadryl and certraline). Yesterday, Feb 9th, an allergist confirmed it is definitely a drug rash and put me on Prednisone and Zyrtec. They will see me again Feb 22 before my currently scheduled 2nd dose of Mar 3.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-10
    Report sent to call center — day 21, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-02-17
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  15. 2021-02-24
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  16. 2021-03-05
    Health check-in — day 42, dose 1
    Feeling: Fair
    Adult check-in
  17. 2021-04-21
    Survey response — 3 months, dose 1
    MedDRA: Fatigue, Myalgia, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities
    Free text: Day after 2nd moderna shot: muscle ache, fatigue, sore arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-06-21
  19. 2022-01-22
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-20Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-02-03 Unsuccessful
2021-02-10 Unsuccessful

Free text

Release 2 — day 7, dose 1

2021-01-27

Systemic reaction (other): Hives around my neck

Release 3 — day 14, dose 1

2021-02-03

Symptoms: Hives, terrible rash that reminds me of chicken pox because it is mainly on my trunk area, though started around filler bone, itchy neck,

Release 4 — day 21, dose 1

2021-02-10

Symptoms: Moderna dose 1 took place Jan 20. On Jan 26 noticed a significant itchy rash that has continued since, first on collar bone and shoulders, then progressed to general trunk area, then arms, then scalp.
Healthcare visit (other): The nurse practitioner see at (b)(6) on Feb 1 did not think it was vaccine related and sent me home with nothing other than suggesting I push back the second dose. (I was already taking benadryl and certraline). Yesterday, Feb 9th, an allergist confirmed it is definitely a drug rash and put me on Prednisone and Zyrtec. They will see me again Feb 22 before my currently scheduled 2nd dose of Mar 3.
redacted (b)(6)

Release 7 — 3 months, dose 1

2021-04-21

Symptoms: Day after 2nd moderna shot: muscle ache, fatigue, sore arm

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
HCVOUnevaluable event ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDRash pruritic ✓ ✓ ✓
SDUrticaria ✓ ✓ ✓
SROUrticaria ✓ ✓ ✓

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