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ZPM-15704-52367

2 vaccinations 3 coded responses 14 check-ins 3 free-text entries 0 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
731 / OK
Registered
2021-03-04
Relationship
Self
Race
Multiracial
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-04
    Registered in v-safe
  2. 2021-03-04
    Dose 1 — Moderna
  3. 2021-03-04
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-03-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injected limb mobility decreased, Nausea, Pain in extremity, Sleep disorder — Feeling: Good · Site: Pain
    Free text: Yesterday when I did the survey my arm kinda hurt but continually hurt more if I tried to raise it. If I raised it above my head it made me nauseous. The arm muscle didnt hurt if it was down. I was unable to sleep on my left side since my left arm hurt.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  10. 2021-03-11
    Health check-in — day 7, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  11. 2021-03-18
    Survey response — day 14, dose 1
    MedDRA: Rash pruritic — Feeling: Good
    Free text: On 8th day after vaccine I had a itchy rash on my shot arm that lasted 1 1/2 days then went away
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-25
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-01
    Dose 2 — Moderna
  14. 2021-04-01
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  15. 2021-04-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Somnolence — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: I went back to bed most of the day & got up at 3:50pm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  17. 2021-07-03
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-04Moderna
22021-04-01Moderna

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Yesterday when I did the survey my arm kinda hurt but continually hurt more if I tried to raise it. If I raised it above my head it made me nauseous. The arm muscle didnt hurt if it was down. I was unable to sleep on my left side since my left arm hurt.

Release 5 — day 14, dose 1

2021-03-18

Symptoms: On 8th day after vaccine I had a itchy rash on my shot arm that lasted 1 1/2 days then went away

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): I went back to bed most of the day & got up at 3:50pm.

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
SDRash pruritic ✓ ✓ ✓
SROInjected limb mobility decreased ✓ ✓ ✓
SRONausea ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROSleep disorder ✓ ✓ ✓
SROSomnolence ✓ ✓ ✓

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