2HP-10790-85942

2 vaccinations 8 coded responses 12 check-ins 8 free-text entries 6 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 633 / MO
Registered: 2021-03-27

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-01
Dose 1 — Moderna
2021-03-27
Registered in v-safe
2021-03-27
Dose 2 — Moderna
2021-03-27
Survey response — day 21, dose 1
MedDRA: Blindness, Magnetic resonance imaging abnormal, Optic nerve disorder, Optic neuritis, Pre-existing disease — Feeling: Good · 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 visit, Hospitalization

Free text: Optic neuritis in left eye started about 3/7. CT scan 3/13 due to darkening vision loss. Optic nerve swelling. Angiogram 3/15. MRI 3/19 showed swelling. Steroid infusion March 3/20. Prednisolone since 3/20. My other eye is blind since infancy.(b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Optic neuritis — 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, Emergency room or emergency department visit, Hospitalization

Free text: Optic neuritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Optic neuritis — 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, Emergency room or emergency department visit, Hospitalization

Free text: Optic neuritis continuing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Visual field defect, Visual impairment — 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: Visual symptoms continue; holes in vision field; treatment cont

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Optic neuritis — 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

Free text: Optic neuritis continues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Optic neuritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Optic neuritis continues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 7, dose 2
MedDRA: Optic neuritis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Optic neuritis continues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-17
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-10
Survey response — day 42, dose 2
MedDRA: Optic neuritis — 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: Optic neuritis continues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-09-25
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-27	Moderna

Call center

6 call center cases

6 successful

VAERS report filed, before or during a call: 6

See the call center timeline

Free text

Release 6 — day 21, dose 1

2021-03-27

Symptoms: Optic neuritis in left eye started about 3/7. CT scan 3/13 due to darkening vision loss. Optic nerve swelling. Angiogram 3/15. MRI 3/19 showed swelling. Steroid infusion March 3/20. Prednisolone since 3/20. My other eye is blind since infancy.(b)(6) cut off by CDC

redacted (b)(6)

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): Optic neuritis

2021-03-29

Systemic reaction (other): Optic neuritis continuing

2021-03-30

Systemic reaction (other): Visual symptoms continue; holes in vision field; treatment cont

2021-03-31

Systemic reaction (other): Optic neuritis continues

2021-04-02

Systemic reaction (other): Optic neuritis continues

Release 6 — day 7, dose 2

2021-04-03

Systemic reaction (other): Optic neuritis continues.

Release 8 — day 42, dose 2

2021-05-10

Symptoms: Optic neuritis continues

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	Blindness	✓	✓	✓
SD	Magnetic resonance imaging abnormal	✓	✓	✓
SD	Optic nerve disorder	✓	✓	✓
SD	Optic neuritis	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Optic neuritis	✓	✓	✓
SRO	Visual field defect	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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