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ZM5-18699-58817

3 vaccinations 22 coded responses 38 check-ins 22 free-text entries 0 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
566 / MN
Registered
2021-04-27
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
64Z-29505-42059 Child or adolescent in my care · Male · 2021-11-07

Timeline

  1. 2021-04-27
    Registered in v-safe
  2. 2021-04-27
    Dose 1 — Moderna
  3. 2021-04-27
    Survey response — day 0, dose 1
    MedDRA: Hypoaesthesia — Feeling: Good
    Free text: Left arm felt numb-like as if it fell asleep.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-28
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hypoaesthesia, Muscle tightness — Feeling: Good · Site: Pain
    Free text: Arm still feels numb-like periodically as if it fell asleep. Neck muscles are tighter today as well.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-29
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling abnormal, Injection site pain, Myalgia — Feeling: Good
    Free text: Arm still feels weird on day three. Neck muscles are still tender. Administer site is barely sore anymore.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-30
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pruritus — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: Inside my right ankle has a small patch that itches. Monitoring and thinking may be poison ivy but we live in (b)(6) MN and its barely May so hence the monitoring.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Muscle tightness — Feeling: Good
    Free text: Upper back and neck muscles are still tense since the day after receiving vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Muscle tightness, Myalgia — Feeling: Good
    Free text: My neck muscles, especially the side I had my shot, are still very tense and sore a week later.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-05
    Survey response — day 7, dose 1
    MedDRA: Fatigue — Feeling: Good
    Free text: Overly tired now
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-11
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-05-18
    Survey response — day 21, dose 1
    MedDRA: Bone pain, Myalgia, Pain in extremity — Feeling: Fair
    Free text: Left arm has been sore in the lower extremities. Cant tell if it muscle soreness or bone soreness.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-26
    Dose 2 — Moderna
  13. 2021-05-26
    Survey response — day 0, dose 2
    MedDRA: Paraesthesia — Feeling: Good · Site: Pain
    Free text: Arm got tingly again like the first shot. Not as aggressive as first dose.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Bones that have been previously broken are extremely achey.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site
    Adult check-in
  16. 2021-05-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle tightness, Myalgia, Vaccine positive rechallenge — Feeling: Good
    Free text: Neck muscles are very tight and sore like the first dose.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-05-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chest discomfort, Cough, Hyperventilation — Feeling: Good
    Free text: Chest was tight and deep breaths were shallow with a sudden cough
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-05-31
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle tightness — Feeling: Good
    Free text: Neck muscles tight still.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-06-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle tightness — Feeling: Good · Nausea
    Free text: Neck muscles are still very tense even after utilizing yoga and hot tub.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-06-02
    Survey response — day 7, dose 2
    MedDRA: Muscle tightness — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Neck muscles still overly tight
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-06-09
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-06-16
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-06-23
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-06-30
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-07-07
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-08-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-11-24
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-12-27
    Dose 3 — Moderna
  29. 2021-12-28
    Survey response — days 1–6 daily, dose 3
    MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: Fingertips going numb
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-12-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Free text: Lymph node in the arm pit extremely swollen
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-12-31
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain
    Free text: Arm pit lymph node still swollen four days later
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-01-01
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain
    Free text: Arm pit lymph node swollen
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-01-02
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy — Feeling: Good
    Free text: Arm pit lymph node still swollen one full week later
    MedDRA releases: 2024-11 · check-in free text available
  34. 2022-01-03
    Survey response — day 7, dose 3
    MedDRA: Lymphadenopathy — Feeling: Good · Site: Itching
    Free text: Arm pit lymph node is still slightly swollen. Definitely reducing in size.
    MedDRA releases: 2024-11 · check-in free text available
  35. 2022-01-10
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-01-18
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  37. 2022-01-24
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  38. 2022-01-31
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  39. 2022-02-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-03-28
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  41. 2022-06-27
    Survey response — 6 months, dose 3
    MedDRA: Chest discomfort, Cough, Ear discomfort, Nasal congestion, Rhinorrhoea — Feeling: Good
    Free text: Runny nose, cough, stuffy head, plugged ears, chest heavy
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-12-27
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-27Moderna
22021-05-26Moderna
32021-12-27Moderna No

Free text

Release 8 — day 0, dose 1

2021-04-27

Systemic reaction (other): Left arm felt numb-like as if it fell asleep.

Release 8 — days 1–6 daily, dose 1

2021-04-28

Systemic reaction (other): Arm still feels numb-like periodically as if it fell asleep. Neck muscles are tighter today as well.

2021-04-29

Systemic reaction (other): Arm still feels weird on day three. Neck muscles are still tender. Administer site is barely sore anymore.

2021-04-30

Systemic reaction (other): Inside my right ankle has a small patch that itches. Monitoring and thinking may be poison ivy but we live in (b)(6) MN and its barely May so hence the monitoring.
redacted (b)(6)

2021-05-02

Systemic reaction (other): Upper back and neck muscles are still tense since the day after receiving vaccine.

2021-05-03

Systemic reaction (other): My neck muscles, especially the side I had my shot, are still very tense and sore a week later.

Release 8 — day 7, dose 1

2021-05-05

Systemic reaction (other): Overly tired now

Release 8 — day 21, dose 1

2021-05-18

Symptoms: Left arm has been sore in the lower extremities. Cant tell if it muscle soreness or bone soreness.

Release 8 — day 0, dose 2

2021-05-26

Systemic reaction (other): Arm got tingly again like the first shot. Not as aggressive as first dose.

Release 8 — days 1–6 daily, dose 2

2021-05-27

Systemic reaction (other): Bones that have been previously broken are extremely achey.

2021-05-29

Systemic reaction (other): Neck muscles are very tight and sore like the first dose.

2021-05-30

Systemic reaction (other): Chest was tight and deep breaths were shallow with a sudden cough

2021-05-31

Systemic reaction (other): Neck muscles tight still.

2021-06-01

Systemic reaction (other): Neck muscles are still very tense even after utilizing yoga and hot tub.

Release 8 — day 7, dose 2

2021-06-02

Systemic reaction (other): Neck muscles still overly tight

Release 10 — days 1–6 daily, dose 3

2021-12-28

Systemic reaction (other): Fingertips going numb

2021-12-29

Systemic reaction (other): Lymph node in the arm pit extremely swollen

2021-12-31

Systemic reaction (other): Arm pit lymph node still swollen four days later

2022-01-01

Systemic reaction (other): Arm pit lymph node swollen

2022-01-02

Systemic reaction (other): Arm pit lymph node still swollen one full week later

Release 10 — day 7, dose 3

2022-01-03

Systemic reaction (other): Arm pit lymph node is still slightly swollen. Definitely reducing in size.

Release 12 — 6 months, dose 3

2022-06-27

Symptoms: Runny nose, cough, stuffy head, plugged ears, chest heavy

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
SDBone pain ✓ ✓ ✓
SDChest discomfort · · ✓
SDCough · · ✓
SDEar discomfort · · ✓
SDMyalgia ✓ ✓ ✓
SDNasal congestion · · ✓
SDPain in extremity ✓ ✓ ✓
SDRhinorrhoea · · ✓
SROChest discomfort ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROCough ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROHyperventilation ✓ ✓ ✓
SROHypoaesthesia ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROLymphadenopathy · · ✓
SROMuscle tightness ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SROParaesthesia ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROVaccine positive rechallenge ✓ ✓ ✓

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

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