6D2-15094-68634
4 vaccinations
4 coded responses
11 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 217 / MD
- Registered
- 2022-10-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Dose 1 — Moderna
-
2021-03-02
Dose 2 — Moderna
-
2021-11-03
Dose 3 — Moderna
-
2022-10-03
Dose 4 — Moderna
-
2022-10-04
Registered in v-safe
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2022-10-04
Survey response — days 1–6 daily, dose 4MedDRA: Neurological symptom — Feeling: Poor · Site: Pain, Swelling · Fatigue or tirednessFree text: I've had some Bell's Palsy like symptoms of the left side of my faceMedDRA releases: 2024-11 · check-in free text available
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2022-10-06
Survey response — days 1–6 daily, dose 4MedDRA: Bell's palsy — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I developed a left sided Bell's Palsy less than 40 hrs after vaccinationMedDRA releases: 2024-11 · check-in free text available
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2022-10-06
Report sent to call center — days 1–6 daily, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
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2022-10-07
Call successfulCompleted over the phone
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2022-10-08
Survey response — days 1–6 daily, dose 4MedDRA: Emergency care, Eyelid disorder, Facial paralysis — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Systemic reaction (other): Still have left sided facial drooping but with slight improvement on steroid treatment · Healthcare visit (other): Only one visit to ER. I'm having trouble doing things because my left eye lid doesn't close well.MedDRA releases: 2024-11 · check-in free text available
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2022-10-08
Report sent to call center — days 1–6 daily, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-10-10
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2022-10-11
Call successfulReported to VAERS during previous contact from GDIT
- 2022-10-17
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2022-10-24
Survey response — day 21, dose 4MedDRA: Office visit, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I developed a bad upper respiratory infection requiring a visit to the doctor and and an antibiotic. · Healthcare visit (other): Office visit to my health care provider.MedDRA releases: 2024-11 · check-in free text available
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2022-10-24
Report sent to call center — day 21, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-10-27
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2023-01-02
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | No |
| 2 | 2021-03-02 | Moderna | No |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-10-03 | Moderna | No |
Call center
3 call center cases
2 successful · 1 unsuccessful
VAERS report filed, before or during a call: 3
Free text
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): I've had some Bell's Palsy like symptoms of the left side of my face
Systemic reaction (other): I developed a left sided Bell's Palsy less than 40 hrs after vaccination
Systemic reaction (other): Still have left sided facial drooping but with slight improvement on steroid treatment
Healthcare visit (other): Only one visit to ER. I'm having trouble doing things because my left eye lid doesn't close well.
Release 12 — day 21, dose 4
Symptoms: I developed a bad upper respiratory infection requiring a visit to the doctor and and an antibiotic.
Healthcare visit (other): Office visit to my health care provider.
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 | Emergency care | · | · | ✓ |
| HCVO | Eyelid disorder | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Bell's palsy | · | · | ✓ |
| SRO | Facial paralysis | · | · | ✓ |
| SRO | Neurological symptom | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release