YKA-17760-80359
2 vaccinations
6 coded responses
21 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 600 / IL
- Registered
- 2021-01-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-30
Dose 1 — Moderna
-
2021-01-31
Registered in v-safe
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2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Injection site streaking, Neck pain, Office visit, Pyrexia — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Fever red streaking of the arm and very hard and pain up in The neck I did go to my doctor · Healthcare visit (other): Family doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-01
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-02
Survey response — days 1–6 daily, dose 1MedDRA: Office visit — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Went back to doctor upon there request on yesterdays visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-02
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-03
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2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Neck pain — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body achesFree text: Soreness up into my neckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Injection site hypoaesthesia, Pallor, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body achesFree text: My arm last night fell very numb about the shot site and below answer my hand with the swelling and all fingers and my skin turns pale gray it lasted for about 35 minutes and lots of numbness right now the arm feels so soMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — day 7, dose 1MedDRA: Neck pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · HeadacheFree text: Upper arm pain into the neckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-20
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2021-02-27
Dose 2 — Moderna
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2021-02-27
Health check-in — day 0, dose 2Feeling: Fair · Site: Redness · Fever · Chills, Headache, Fatigue or tiredness, NauseaAdult check-in
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2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
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2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-05
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
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2021-05-29
Survey response — 3 months, dose 2MedDRA: Pain in extremity — Feeling: GoodFree text: My left arm still soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-14
- 2021-06-17
- 2021-08-28
- 2022-02-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-01 | Unsuccessful | |
| 2021-02-02 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Fever red streaking of the arm and very hard and pain up in The neck I did go to my doctor
Healthcare visit (other): Family doctor
Healthcare visit (other): Went back to doctor upon there request on yesterdays visit
Systemic reaction (other): Soreness up into my neck
Systemic reaction (other): My arm last night fell very numb about the shot site and below answer my hand with the swelling and all fingers and my skin turns pale gray it lasted for about 35 minutes and lots of numbness right now the arm feels so so
Release 3 — day 7, dose 1
Systemic reaction (other): Upper arm pain into the neck
Release 8 — 3 months, dose 2
Symptoms: My left arm still sore
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Injection site hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Injection site streaking | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pallor | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release