Y3N-18729-39774

2 vaccinations 12 coded responses 22 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 462 / IN
Registered: 2021-04-10

Relationship: Self
Race: American Indian or Alaska Native
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-09
Dose 1 — Moderna
2021-04-10
Registered in v-safe
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Pulse was high, 122 while laying down.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pain in jaw — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: My jaw and below my ears hurt.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia oral — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Dead area on my tongue. Smelling things that aren't there.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis, Night sweats, Paraesthesia oral — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness

Free text: Sweating all night and most of day. Tongue still dead in center.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Eye pain, Hyperacusis, Paraesthesia oral, Parosmia, Tongue disorder — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dead area on tongue, phantom smells, eye pain and my ears are sensitive to certain sounds.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 7, dose 1
MedDRA: Hypoaesthesia oral — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Tongue still numb

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-07
Dose 2 — Moderna
2021-05-07
Survey response — day 0, dose 2
MedDRA: Eye pain, Hypoaesthesia oral — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Tongue is numb. Eye pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Eye pain, Muscle spasms, Parosmia, Taste disorder — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Cramping, eye pain, strange pain and sound in ears, coughing, strange tastes and smells,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dysgeusia, Hypoaesthesia oral, Paraesthesia, Parosmia, Sneezing, Tinnitus — Feeling: Fair · Site: Redness, Itching · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Ears making strange sounds, still phantom smells and tastes, tongue still numb, nose tingles like ur gonna sneeze but dont.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Eye pain, Hypoaesthesia oral, Parosmia, Taste disorder — Feeling: Fair · Site: Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Eye pain. Tongue still numb. Strange taste. Phantom smells. Brain fog..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 7, dose 2
MedDRA: Brain fog, Hypoaesthesia oral, Parosmia — Feeling: Fair · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Brain fog. Tongue numb. Phantom smells.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-05-10
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Fair · 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: I had COVID again in December 2021

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Moderna
2	2021-05-07	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-05-10	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Pulse was high, 122 while laying down.

2021-04-11

Systemic reaction (other): My jaw and below my ears hurt.

2021-04-12

Systemic reaction (other): Dead area on my tongue. Smelling things that aren't there.

2021-04-14

Systemic reaction (other): Sweating all night and most of day. Tongue still dead in center.

2021-04-15

Systemic reaction (other): Dead area on tongue, phantom smells, eye pain and my ears are sensitive to certain sounds.

Release 7 — day 7, dose 1

2021-04-16

Systemic reaction (other): Tongue still numb

Release 8 — day 0, dose 2

2021-05-07

Systemic reaction (other): Tongue is numb. Eye pain.

Release 8 — days 1–6 daily, dose 2

2021-05-10

Systemic reaction (other): Cramping, eye pain, strange pain and sound in ears, coughing, strange tastes and smells,

2021-05-12

Systemic reaction (other): Ears making strange sounds, still phantom smells and tastes, tongue still numb, nose tingles like ur gonna sneeze but dont.

2021-05-13

Systemic reaction (other): Eye pain. Tongue still numb. Strange taste. Phantom smells. Brain fog..

Release 8 — day 7, dose 2

2021-05-14

Systemic reaction (other): Brain fog. Tongue numb. Phantom smells.

Release 11 — 12 months, dose 2

2022-05-10

Symptoms: I had COVID again in December 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

Field	Preferred term	2021-09	2023-04	2024-11
SD	COVID-19	·	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Ear pain	✓	✓	○
SRO	Eye pain	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hyperacusis	·	·	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Tongue disorder	·	·	✓

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