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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

  1. 2021-04-08
    Registered in v-safe
  2. 2021-04-08
    Dose 1 — Moderna
  3. 2021-04-08
    Survey response — day 0, dose 1
    MedDRA: 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 activities
    Free 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
  4. 2021-04-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-04-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pharyngeal swelling — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Throat still seems swollen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-04-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Be unable to do your normal daily activities
    Free 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
  8. 2021-04-15
    Survey response — day 7, dose 1
    MedDRA: 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 activities
    Free 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
  9. 2021-04-22
    Survey response — day 14, dose 1
    MedDRA: Pain in extremity, Rash — Feeling: Good
    Free 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
  10. 2022-04-10
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-08Moderna

Free text

Release 7 — day 0, dose 1

2021-04-08

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

2021-04-11

Systemic reaction (other): Throat still seems swollen

2021-04-14

Systemic reaction (other): My armpit on the arm I had the shot is swollen and extremely painful now.

Release 7 — day 7, dose 1

2021-04-15

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

2021-04-22

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

FieldPreferred term2021-092023-042024-11
SDPain in extremity ✓ ✓ ✓
SDRash ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROOedema peripheral ✓ ✓ ✓
SROOral pruritus ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROParaesthesia oral ✓ ✓ ✓
SROPharyngeal swelling ✓ ✓ ✓
SROSensation of foreign body ✓ ✓ ✓

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