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YM3-21785-70248

2 vaccinations 8 coded responses 15 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
580 / ND
Registered
2021-01-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2020-12-28
    Dose 1 — Moderna
  2. 2021-01-21
    Registered in v-safe
  3. 2021-01-21
    Dose 2 — Moderna
  4. 2021-01-21
    Survey response — day 21, dose 1
    MedDRA: Hypoaesthesia, Injection site bruising, Injection site rash, Paraesthesia — Feeling: Good
    Free text: had numbness and tingling in hands and feet had bruising around anrash around injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-21
    Survey response — day 0, dose 2
    MedDRA: Injection site pain — Feeling: Good · Site: Pain, Redness · Muscle or body aches
    Free text: sore arm at injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches
    Free text: Lyphnodes swollen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches
    Free text: Upper Arm swelled up ,large red spot whole deltoid
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-01-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches
    Free text: Deltoid
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-01-28
    Survey response — day 7, dose 2
    MedDRA: Rash, Skin discolouration — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site
    Free text: Left deltiod and upper arm left a discoloration from rash whole upper arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-04
    Survey response — day 14, dose 2
    MedDRA: Hypoaesthesia, Injection site pain, Injection site rash, Injection site swelling — Feeling: Good
    Free text: Intermittent numbness in in my arm and still have pain i deltoid at times .I have amark the size of palm left over from the rash and swelling in my upper arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-11
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-02-18
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-02-25
    Survey response — day 35, dose 2
    MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Good
    Free text: I keep getting intermittent numbness tinging in my left am
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-04
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-04-22
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-07-22
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2022-01-21
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12020-12-28Moderna
22021-01-21Moderna

Free text

Release 2 — day 0, dose 2

2021-01-21

Systemic reaction (other): sore arm at injection site

Release 2 — day 21, dose 1

2021-01-21

Symptoms: had numbness and tingling in hands and feet had bruising around anrash around injection site

Release 2 — days 1–6 daily, dose 2

2021-01-22

Systemic reaction (other): Lyphnodes swollen

2021-01-23

Systemic reaction (other): Upper Arm swelled up ,large red spot whole deltoid

2021-01-24

Systemic reaction (other): Deltoid

Release 3 — day 7, dose 2

2021-01-28

Systemic reaction (other): Left deltiod and upper arm left a discoloration from rash whole upper arm

Release 3 — day 14, dose 2

2021-02-04

Symptoms: Intermittent numbness in in my arm and still have pain i deltoid at times .I have amark the size of palm left over from the rash and swelling in my upper arm

Release 4 — day 35, dose 2

2021-02-25

Symptoms: I keep getting intermittent numbness tinging in my left am

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
SDHypoaesthesia ✓ ✓ ✓
SDInjection site bruising ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDInjection site swelling ✓ ✓ ✓
SDParaesthesia ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SRORash ✓ ✓ ✓
SROSkin discolouration ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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

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