YNW-93942-83073
2 vaccinations
4 coded responses
23 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 851 / AZ
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
-
2021-02-12
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
-
2021-03-06
Survey response — day 21, dose 2MedDRA: Bell's palsy, Choking, Dysphagia, Emergency care, Eyelid function disorder, Facial paralysis, Vision blurred — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: I have been diagnosed as having Bells Palsy, my right side of my face has dropped, my right eyelid wont close., slightly blurred in my left eye. When I eat I have some problem swallowing, with slight choking. · Healthcare visit (other): After emergency room visit, also now under eye doctor care for my right eyeeyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-12
Survey response — day 28, dose 2MedDRA: Bell's palsy, Chronic cheek biting, Facial paralysis, Hypoacusis, Hypoaesthesia oral, Vision blurred — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: With my Bells palsy. My eye still slightly blurry, tongue numb, my right side of face droopy, biting my inner check , my hearing is not good.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Report sent to call center — day 28, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-19
- 2021-03-26
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2021-05-14
Survey response — 3 months, dose 2MedDRA: Bell's palsy — Feeling: Good · Be unable to workFree text: Bells palsyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-12-15
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-06 | Successful | Participant prefers to complete VAERS report online |
| 2021-03-12 | Successful 2021-12-15 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): None
Release 5 — day 21, dose 2
Symptoms: I have been diagnosed as having Bells Palsy, my right side of my face has dropped, my right eyelid wont close., slightly blurred in my left eye. When I eat I have some problem swallowing, with slight choking.
Healthcare visit (other): After emergency room visit, also now under eye doctor care for my right eyeeye
Release 5 — day 28, dose 2
Symptoms: With my Bells palsy. My eye still slightly blurry, tongue numb, my right side of face droopy, biting my inner check , my hearing is not good.
Release 8 — 3 months, dose 2
Symptoms: Bells palsy
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 | ✓ | ✓ | ✓ |
| SD | Bell's palsy | ✓ | ✓ | ✓ |
| SD | Choking | ✓ | ✓ | ✓ |
| SD | Chronic cheek biting | ✓ | ✓ | ✓ |
| SD | Dysphagia | ✓ | ✓ | ✓ |
| SD | Eyelid function disorder | ✓ | ✓ | ✓ |
| SD | Facial paralysis | ✓ | ✓ | ✓ |
| SD | Hypoacusis | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SD | Vision blurred | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release