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
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Hypoaesthesia, Injection site hypoaesthesia — Feeling: Fair · Site: Pain · FeverFree 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
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Neuralgia, Pain in extremity — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesFree 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
- 2021-01-28
- 2021-02-02
- 2021-02-11
-
2021-02-16
Dose 2 — Moderna
-
2021-02-16
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: 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 activitiesAdult check-in
- 2021-02-18
- 2021-02-22
- 2021-02-25
- 2021-03-02
- 2021-03-09
- 2021-08-17
-
2021-12-31
Dose 3 — Moderna
-
2022-02-16
Survey response — 12 months, dose 2MedDRA: Pregnancy — Feeling: Fair · Be unable to work or attend schoolFree text: PregnancyMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-12-31 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
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.
Systemic reaction (other): Moderate- severe pain down arm from injection site. Seems to follow radial nerve.
Release 11 — 12 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Pregnancy | · | · | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Injection site hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Neuralgia | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release