5XM-27855-55901

1 vaccination 11 coded responses 16 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 085 / NJ
Registered: 2021-06-20

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-06-20
Registered in v-safe
2021-06-20
Dose 1 — Moderna
2021-06-20
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-21
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Paraesthesia oral — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Feels something my lymph notes around base of tongue but no pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia — Feeling: Fair · Fatigue or tiredness

Free text: Feeling slight numbness in my hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Hypoaesthesia, Middle insomnia — Feeling: Fair · Fatigue or tiredness

Free text: Feeling numbness in hands and left arm. Woke up in the middle of night with rushing feeling but no pain and went back to sleep after a few minutes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Sensory disturbance — Feeling: Fair

Free text: Feeling funny in left arm and numbness in my left hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary mass, Breast mass, Hypoaesthesia — Feeling: Fair

Free text: Feeling numbness in my hands and a lump probably lymph node between left breast and underarm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Dysgeusia, Lymphadenopathy — Feeling: Fair

Free text: Feeling a lump maybe lymph node between left chest and underarm. Left lightheaded last night for a few minutes. Always tasting salty in mouth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Survey response — day 7, dose 1
MedDRA: Discomfort, Hypoaesthesia — Feeling: Fair · Fatigue or tiredness

Free text: Slight numbness in my left hand, feeling uncomfortable around lymph node near left chest & underarm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-04
Survey response — day 14, dose 1
MedDRA: Hypoaesthesia, Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Muscular weakness — Feeling: Fair

Free text: Just below the shot area became red and swollen a bit. It was hot and hardened, and itchy. It lasted a 3-4 days. Now it subsided a lot. Only shows light red. Continue to have a bit of numbness and weakness in left hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Survey response — day 21, dose 1
MedDRA: Discomfort, Lymph node pain, Lymphadenopathy — Feeling: Fair

Free text: I feel lymph node in my left throat swollen. Both sides were a little swollen before but subsided. When I touch, I feel a little pain. I feel ramp and uncomfortable underarm lymph nodes,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-18
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-07-25
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-08-02
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-09-19
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-12-19
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2022-06-20
Survey response — 12 months, dose 1
MedDRA: Rash — Feeling: Fair

Free text: Rashes

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-20	Moderna	No

Free text

Release 9 — day 0, dose 1

2021-06-20

Systemic reaction (other): Light headed

Release 9 — days 1–6 daily, dose 1

2021-06-21

Systemic reaction (other): Feels something my lymph notes around base of tongue but no pain

2021-06-22

Systemic reaction (other): Feeling slight numbness in my hands

2021-06-23

Systemic reaction (other): Feeling numbness in hands and left arm. Woke up in the middle of night with rushing feeling but no pain and went back to sleep after a few minutes.

2021-06-24

Systemic reaction (other): Feeling funny in left arm and numbness in my left hand

2021-06-25

Systemic reaction (other): Feeling numbness in my hands and a lump probably lymph node between left breast and underarm.

2021-06-26

Systemic reaction (other): Feeling a lump maybe lymph node between left chest and underarm. Left lightheaded last night for a few minutes. Always tasting salty in mouth.

Release 9 — day 7, dose 1

2021-06-27

Systemic reaction (other): Slight numbness in my left hand, feeling uncomfortable around lymph node near left chest & underarm

Release 9 — day 14, dose 1

2021-07-04

Symptoms: Just below the shot area became red and swollen a bit. It was hot and hardened, and itchy. It lasted a 3-4 days. Now it subsided a lot. Only shows light red. Continue to have a bit of numbness and weakness in left hand

Release 9 — day 21, dose 1

2021-07-11

Symptoms: I feel lymph node in my left throat swollen. Both sides were a little swollen before but subsided. When I touch, I feel a little pain. I feel ramp and uncomfortable underarm lymph nodes,

Release 12 — 12 months, dose 1

2022-06-20

Symptoms: Rashes

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	Discomfort	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site induration	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Lymph node pain	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Rash	·	·	✓
SRO	Axillary mass	✓	✓	✓
SRO	Breast mass	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Sensory disturbance	✓	✓	✓

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