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Report #2861382

Received Sep 25, 2025

Office visit
A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Male
Age
36 yrs
State
NC
Recovered
Not recovered
Vaccinated
Dec 30, 2020
Onset
Aug 23, 2021
Days to onset
236
Hospital days
—

Vaccines (3)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA1011J02ASYR / LA
COVID19COVID19 (COVID19 (MODERNA))MODERNA2042L20ASYR / LA
COVID19COVID19 (COVID19 (MODERNA))MODERNA3036C21ASYR / LA

Symptoms (11)

ErythemaFatigueHeadacheIdiopathic urticariaPapulePruritusRashSeborrhoeic dermatitisSkin plaqueUrticariaUrticaria chronic

Symptom narrative

On 08/23/2021, the patient presented with intermittent hives and rashes. Episodes over the past few months included scattered papules, erythema, and wheals on the elbow and shoulder, accompanied by itching. These rashes appeared periodically, lasting for a day before resolving, and recurred over the following months. Hydrocortisone cream was attempted without significant relief. Dermatology later diagnosed idiopathic urticaria (11/30/2021). Condition persisted intermittently despite symptomatic treatment with antihistamines. On 02/28/2022, dermatology noted chronic spontaneous urticaria with associated fatigue. Fatigue became an ongoing symptom, persisting alongside the recurring hives and dermatitis. 08/23/2021 ? Rash/Hives: Intermittent breakouts of hives and rashes (papules, erythema, wheals on elbow/shoulder). 11/30/2021 ? Rash/Hives confirmed: Dermatology visit; diagnosed idiopathic urticaria (itchy papules and plaques on arms and trunk recurring for 4?5 months). 02/28/2022 ? Chronic Fatigue: Dermatology documented chronic spontaneous urticaria with associated fatigue; also noted seborrheic dermatitis. Mid-2022 ? Headaches: Multiple follow-ups included recurring headaches and migraines, persisting alongside fatigue. 2022?2023 ? Dizziness: Episodes of dizziness/vertigo in connection with ongoing fatigue and headaches. 2023 ? Shortness of Breath: Intermittent dyspnea/chest tightness noted during routine evaluations. Ongoing ? Nausea: Treated intermittently with promethazine 25 mg as needed; tied to post-vaccine complaints.

Current illness

None

Medical history

Migraines, Degenerative joint disease

Other medications

Witch hazel pads ? topical use Carboxymethylcellulose sodium (artificial tears) ? ophthalmic drops Promethazine 25 mg ? as needed for nausea/vomiting Naproxen 500 mg ? oral, for pain/inflammation Ibuprofen 800 mg ? oral, with food as ne

Allergies

NKDA

Lab data

Dermatology evaluation on 11/30/2021: diagnosed idiopathic urticaria; noted itchy papules and plaques of arms and trunk with no known triggers Dermatology follow-up on 02/28/2022: chronic spontaneous urticaria and seborrheic dermatitis noted

Prior vaccinations

Small Pox (May 2003)