25A-61768-13366

2 vaccinations 15 coded responses 23 check-ins 15 free-text entries 1 call case

Sex: Male
Age at first dose: 61-65
ZIP prefix: 811 / CO
Registered: 2021-02-11

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-11
Survey response — day 0, dose 1
MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work

Free text: Numbness on my face, including my nose, lips, chin and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Numbness in face. Nose, lips, chin, jaw area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness, Diarrhea

Free text: Numbness in face. Chin, nose, lips, jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Numbness in chin, lips and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Numbness on lips, chin and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Numbness in face. Chin, lips and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 7, dose 1
MedDRA: Heart rate increased, Hypertension, Hypoaesthesia, Hypoaesthesia oral — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: High blood pressure, high heart rate, numbness in face, chin, lips and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 7, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-11
Survey response — day 0, dose 2
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Numbness in my face, lips, chin, jaw area. Numbness on my arms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Hypoaesthesia oral, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Numbness in face. Chin, jaw, lips. Numbness and swelling in hands.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Numbness in my face, lips chin and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Numbness in face, chin and lips and hands and lower arms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Numbness in face, chin, lips and jaw. Numbness in hands and forearms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Fatigue or tiredness

Free text: Numbness in my face - chin, lips and jaw, hands and forearms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 7, dose 2
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Good · Fatigue or tiredness

Free text: Numbness in face- chin, lips and jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Call 1 — Requested Callback
2021-08-06
Call successful
Participant prefers to complete VAERS report online
2021-09-14
Survey response — 6 months, dose 2
MedDRA: Back pain, Fatigue, Hypertension, Hypoaesthesia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Constant fatigue, lower back pain, high blood pressure, and continued numbness in face.

MedDRA releases: 2024-11 · check-in free text available
no date
Callback requested for
7:15PM ET

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-11

Systemic reaction (other): Numbness on my face, including my nose, lips, chin and jaw.

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): Numbness in face. Nose, lips, chin, jaw area.

2021-02-13

Systemic reaction (other): Numbness in face. Chin, nose, lips, jaw.

2021-02-14

Systemic reaction (other): Numbness in chin, lips and jaw.

2021-02-15

Systemic reaction (other): Numbness on lips, chin and jaw.

2021-02-16

Systemic reaction (other): Numbness in face. Chin, lips and jaw.

Release 4 — day 7, dose 1

2021-02-18

Systemic reaction (other): High blood pressure, high heart rate, numbness in face, chin, lips and jaw.

Release 5 — day 0, dose 2

2021-03-11

Systemic reaction (other): Numbness in my face, lips, chin, jaw area. Numbness on my arms.

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Numbness in face. Chin, jaw, lips. Numbness and swelling in hands.

2021-03-14

Systemic reaction (other): Numbness in my face, lips chin and jaw.

2021-03-15

Systemic reaction (other): Numbness in face, chin and lips and hands and lower arms

2021-03-16

Systemic reaction (other): Numbness in face, chin, lips and jaw. Numbness in hands and forearms.

2021-03-17

Systemic reaction (other): Numbness in my face - chin, lips and jaw, hands and forearms.

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): Numbness in face- chin, lips and jaw.

Release 9 — 6 months, dose 2

2021-09-14

Symptoms: Constant fatigue, lower back pain, high blood pressure, and continued numbness in face.

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	Back pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Hypertension	·	·	✓
SD	Hypoaesthesia	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓

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