68H-25397-82404
2 vaccinations
4 coded responses
10 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 211 / MD
- Registered
- 2021-05-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-22
Dose 1 — Moderna
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2021-05-20
Registered in v-safe
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2021-05-20
Dose 2 — Moderna
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2021-05-20
Survey response — day 0, dose 2MedDRA: Hypoaesthesia, Immediate post-injection reaction — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Approximately 10 minutes after the vaccine I developed tingling and then numbness in my face on the side of the injection site. Also radiating into my ear and loss of hearing on that side. It is lessening but still at 8 hours later I am numb on my left cheek off my face.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-20
Report sent to call center — day 0, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-21
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Face still slightly numb and tingling on left side, the side of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-05-24
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2021-05-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-05-27
- 2021-06-03
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2021-06-10
Survey response — day 21, dose 2MedDRA: Diarrhoea — Feeling: GoodFree text: DiarrheaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-19
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2021-06-30
Survey response — day 35, dose 2MedDRA: Rash, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Rash on chest, possibly Shingles · Healthcare visit (other): In person visit to PCPMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-30
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-06
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-22 | Moderna | |
| 2 | 2021-05-20 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 8 — day 0, dose 2
Systemic reaction (other): Approximately 10 minutes after the vaccine I developed tingling and then numbness in my face on the side of the injection site. Also radiating into my ear and loss of hearing on that side. It is lessening but still at 8 hours later I am numb on my left cheek off my face.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Face still slightly numb and tingling on left side, the side of injection
Release 9 — day 21, dose 2
Symptoms: Diarrhea
Release 9 — day 35, dose 2
Symptoms: Rash on chest, possibly Shingles
Healthcare visit (other): In person visit to PCP
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 |
|---|---|---|---|---|
| HCVO | Specialist consultation | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release