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Y5N-24799-54825

2 vaccinations 8 coded responses 13 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
907 / CA
Registered
2021-02-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-14
    Dose 1 — Moderna
  2. 2021-02-11
    Registered in v-safe
  3. 2021-02-11
    Dose 2 — Moderna
  4. 2021-02-11
    Survey response — day 0, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain
    Free text: My thinking process is slower. Some call it having foggy brain.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary pain, Injection site pain — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Left arm hurts injection site. Left axilla is tender.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to work
    Free text: Left arm still hurts....but better...not as much.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Left arm still hurts
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypoacusis, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Left arm mild tenderness. Does this Vaccine effect your hearing ? I seem to have lost hearing some tones when people speak.?
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-18
    Survey response — day 7, dose 2
    MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Mild pain left arm injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-25
    Survey response — day 14, dose 2
    MedDRA: Hypoacusis — Feeling: Good
    Free text: My hearing has changed. Some tones are hard to hear.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-04
    Survey response — day 21, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Body temperature a little high but still normal range
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-03-25
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-13
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-08-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-14Moderna
22021-02-11Moderna

Free text

Release 4 — day 0, dose 2

2021-02-11

Systemic reaction (other): My thinking process is slower. Some call it having foggy brain.

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Left arm hurts injection site. Left axilla is tender.

2021-02-14

Systemic reaction (other): Left arm still hurts....but better...not as much.

2021-02-16

Systemic reaction (other): Left arm still hurts

2021-02-17

Systemic reaction (other): Left arm mild tenderness. Does this Vaccine effect your hearing ? I seem to have lost hearing some tones when people speak.?

Release 4 — day 7, dose 2

2021-02-18

Systemic reaction (other): Mild pain left arm injection site

Release 4 — day 14, dose 2

2021-02-25

Symptoms: My hearing has changed. Some tones are hard to hear.

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Body temperature a little high but still normal range

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
SDHypoacusis ✓ ✓ ✓
SDUnevaluable event ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROHypoacusis ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓

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

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