5NJ-10028-29392
2 vaccinations
3 coded responses
17 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 981 / WA
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Registered in v-safe
-
2021-01-17
Dose 1 — Moderna
- 2021-01-17
- 2021-01-18
- 2021-01-19
-
2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Eye pain, Hypoaesthesia, Pain, Pain in jaw — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Kinda weird but, I've developed an area of sensitivity, numbness and pain about two inches wide from the right side of the top of my head down through my right eye, cheek and jaw. No loss in ability to move or droopiness on that side but it's getting a bit more intense as the day goes on. Started on Tuesday with just sensitivity.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-21
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-22
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Trigeminal neuralgia — Feeling: Fair · HeadacheFree text: Trigeminal Neuralgia symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-24
Survey response — day 7, dose 1MedDRA: Trigeminal neuralgia — Feeling: Fair · HeadacheFree text: Trigeminal Neuralgia or possibly ShinglesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-07
-
2021-02-14
Dose 2 — Moderna
- 2021-02-23
- 2021-02-28
- 2021-03-09
- 2021-03-14
- 2021-03-21
- 2021-03-26
- 2021-03-28
- 2021-04-01
- 2021-05-16
- 2021-08-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Moderna | |
| 2 | 2021-02-14 | Moderna |
Call center
1 call center case
1 unsuccessful
VAERS report filed, before or during a call: 1
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Kinda weird but, I've developed an area of sensitivity, numbness and pain about two inches wide from the right side of the top of my head down through my right eye, cheek and jaw. No loss in ability to move or droopiness on that side but it's getting a bit more intense as the day goes on. Started on Tuesday with just sensitivity.
Systemic reaction (other): Trigeminal Neuralgia symptoms
Release 2 — day 7, dose 1
Systemic reaction (other): Trigeminal Neuralgia or possibly Shingles
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 |
|---|---|---|---|---|
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Trigeminal neuralgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release