YXV-23801-17339
1 vaccination
5 coded responses
8 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 488 / MI
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
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2021-04-08
Registered in v-safe
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2021-04-08
Dose 1 — Moderna
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2021-04-08
Survey response — day 0, dose 1MedDRA: Immediate post-injection reaction, Oral pruritus, Paraesthesia oral, Sensation of foreign body — Feeling: Poor · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Within 30 minutes had itchy tingly feeling on lips and mouth area. Throat felt tight and like a rock in it or something like that.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-11
Survey response — days 1–6 daily, dose 1MedDRA: Pharyngeal swelling — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: Throat still seems swollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-14
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Be unable to do your normal daily activitiesFree text: My armpit on the arm I had the shot is swollen and extremely painful now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Survey response — day 7, dose 1MedDRA: Chills, Fatigue, Injection site pain, Lymphadenopathy, Pain — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I was feeling better, all of a sudden today injection site hurts again, lymph nodes in armpit are swollen. Major chills happening and tired and sore.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Survey response — day 14, dose 1MedDRA: Pain in extremity, Rash — Feeling: GoodFree text: Arm of injection began hurting again and had a rash again for a day on it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2022-04-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Moderna |
Free text
Release 7 — day 0, dose 1
Systemic reaction (other): Within 30 minutes had itchy tingly feeling on lips and mouth area. Throat felt tight and like a rock in it or something like that.
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Throat still seems swollen
Systemic reaction (other): My armpit on the arm I had the shot is swollen and extremely painful now.
Release 7 — day 7, dose 1
Systemic reaction (other): I was feeling better, all of a sudden today injection site hurts again, lymph nodes in armpit are swollen. Major chills happening and tired and sore.
Release 7 — day 14, dose 1
Symptoms: Arm of injection began hurting again and had a rash again for a day on it.
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 | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Oral pruritus | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Paraesthesia oral | ✓ | ✓ | ✓ |
| SRO | Pharyngeal swelling | ✓ | ✓ | ✓ |
| SRO | Sensation of foreign body | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release