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QYZ-23121-96900

3 vaccinations 3 coded responses 14 check-ins 3 free-text entries 0 call cases
Sex
Female
Age at first dose
21-25
ZIP prefix
840 / UT
Registered
2021-01-19
Relationship
Self
Race
American Indian or Alaska Native
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-01-19
    Registered in v-safe
  2. 2021-01-19
    Dose 1 — Moderna
  3. 2021-01-22
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hypoaesthesia, Injection site hypoaesthesia — Feeling: Fair · Site: Pain · Fever
    Free text: Numbness from injection site to the entire left side of face (vaccine was administered in left shoulder). This was day of injection and lasted approximately 15 minutes. Unable to do health check that day.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-23
    Survey response — days 1–6 daily, dose 1
    MedDRA: Neuralgia, Pain in extremity — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities
    Free text: Moderate- severe pain down arm from injection site. Seems to follow radial nerve.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-28
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-02
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-02-11
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-02-16
    Dose 2 — Moderna
  9. 2021-02-16
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  10. 2021-02-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  11. 2021-02-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  12. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-02-25
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-02
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-09
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-08-17
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-12-31
    Dose 3 — Moderna
  18. 2022-02-16
    Survey response — 12 months, dose 2
    MedDRA: Pregnancy — Feeling: Fair · Be unable to work or attend school
    Free text: Pregnancy
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-19Moderna
22021-02-16Moderna
32021-12-31Moderna No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Numbness from injection site to the entire left side of face (vaccine was administered in left shoulder). This was day of injection and lasted approximately 15 minutes. Unable to do health check that day.

2021-01-23

Systemic reaction (other): Moderate- severe pain down arm from injection site. Seems to follow radial nerve.

Release 11 — 12 months, dose 2

2022-02-16

Symptoms: Pregnancy

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
SDPregnancy · · ✓
SROHypoaesthesia ✓ ✓ ✓
SROInjection site hypoaesthesia ✓ ✓ ✓
SRONeuralgia ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓

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