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26V-16596-90054

2 vaccinations 3 coded responses 4 check-ins 3 free-text entries 3 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
945 / CA
Registered
2021-06-27
Relationship
Self
Race
Multiracial
Ethnicity
Hispanic or Latino

Possible VAERS report

VAERS IDConfidenceScoreRunner-upShared symptomsDose StateVAERS vaccinated / onset / receivedCall case
1454483 (opens in a new window) high 10 / 11 — 3 of 12 VAERS symptoms same dose (2) CA matches 2021-06-01 / 2021-06-01 / 2021-07-07
received the same day as the last call
 case 813340

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

  1. 2021-05-03
    Dose 1 — Moderna
  2. 2021-06-01
    Dose 2 — Moderna
  3. 2021-06-27
    Registered in v-safe
  4. 2021-06-27
    Survey response — day 21, dose 2
    MedDRA: Injection site inflammation, Injection site pain, Office visit, Pain in extremity, Pseudostroke — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: 1st dose was administered on my left arm and I had severe pain for 4 days. 2 dose shot location the same and became inflamed 4 1/2 hours after pain & inflammation for 2 weeks with no flu like symptoms. I went to the doctor due to stroke like symptom.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-06-27
    Report sent to call center — day 21, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-06-29
    Survey response — day 28, dose 2
    MedDRA: Hypoaesthesia, Injection site pain, Unevaluable event, Vision blurred — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Blurry vision, intermittent pain in left arm upper arm (injection site) and numbness on my face and left side of my body. · Healthcare visit (other): CT Scan, blood work
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-06-29
    Report sent to call center — day 28, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  8. 2021-07-07
    Call successful
    Completed over the phone
  9. 2021-07-08
    Survey response — day 35, dose 2
    MedDRA: Hypoaesthesia, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Numbness on face and left arm pain were injection was given. · Healthcare visit (other): Optometrist appointment on 07/09/2021
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-07-08
    Report sent to call center — day 35, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  11. 2021-07-12
    Call successful
    Reported to VAERS during previous contact from GDIT
  12. 2022-06-01
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-05-03Moderna No
22021-06-01Moderna No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 9 — day 21, dose 2

2021-06-27

Symptoms: 1st dose was administered on my left arm and I had severe pain for 4 days. 2 dose shot location the same and became inflamed 4 1/2 hours after pain & inflammation for 2 weeks with no flu like symptoms. I went to the doctor due to stroke like symptom. cut off by CDC

Release 9 — day 28, dose 2

2021-06-29

Symptoms: Blurry vision, intermittent pain in left arm upper arm (injection site) and numbness on my face and left side of my body.
Healthcare visit (other): CT Scan, blood work

Release 9 — day 35, dose 2

2021-07-08

Symptoms: Numbness on face and left arm pain were injection was given.
Healthcare visit (other): Optometrist appointment on 07/09/2021

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
HCVOUnevaluable event ✓ ✓ ✓
SDHypoaesthesia ✓ ✓ ✓
SDInjection site inflammation ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPseudostroke ✓ ✓ ✓
SDVision blurred ✓ ✓ ✓

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

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