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2TP-13286-31150

4 vaccinations 5 coded responses 37 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
321 / FL
Registered
2021-01-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-04
    Registered in v-safe
  2. 2021-01-04
    Dose 1 — Moderna
  3. 2021-01-04
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-01-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-13
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-01-18
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-01-25
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-01
    Dose 2 — Moderna
  14. 2021-02-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills, Hyperaesthesia teeth, Pain, Pyrexia, Sensitivity to weather change — Feeling: Fair · Fatigue or tiredness
    Free text: My teeth are cold and hot sensitive. This is new to me. I also had chills and fever and aches yesterday.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-02-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-08
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-15
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-02-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-08
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-15
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-03
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-08-02
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-10-28
    Dose 3 — Moderna
  28. 2022-02-01
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2022-02-01
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  30. 2022-04-23
    Dose 4 — Moderna
  31. 2022-04-26
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  32. 2022-04-27
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  33. 2022-04-28
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  34. 2022-04-29
    Survey response — days 1–6 daily, dose 4
    MedDRA: Headache — Feeling: Fair · Headache
    Free text: Very slight headache.
    MedDRA releases: 2024-11 · check-in free text available
  35. 2022-04-30
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  36. 2022-05-07
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  37. 2022-05-14
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  38. 2022-05-21
    Survey response — day 28, dose 4
    MedDRA: Cataract operation complication, Office visit — Feeling: Fair · Be unable to work or attend school
    Free text: Had cataract surgery on Tuesday and I am experiencing double vision. My doctor says it will go away but I feel Nauseous when looking out both eyes. Probably has nothing to do with the vaccine but thought I should mention it.
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-05-28
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-06-04
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-07-23
    Survey response — 3 months, dose 4
    MedDRA: Cataract operation, Diplopia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Approximately a month after I had my fourth vaccination I had cataract surgery. My left eye was done first and I developed double vision. My doctor said it was very rare it cleared up within two weeks. My second I was done two weeks later and again I · Healthcare visit (other): Visits back to my eye doctor.
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-07-23
    Report sent to call center — 3 months, dose 4
    Get care from a doctor or other healthcare professional
    1 call case(s)
  43. 2022-07-26
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  44. 2022-10-22
    Survey response — 6 months, dose 4
    MedDRA: Cerebrovascular accident, Dizziness, Emergency care, Hospitalisation, Mobility decreased, SARS-CoV-2 test positive, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization
    Free text: Symptoms: I had a stroke. I am fine with no residual affects from it. While in the hospital they tested me for Covid and told me I Tested positive for Covid. I had no symptoms. · Healthcare visit (other): I was feeling a bit dizzy in the head and decided I should go to emergency while in the emergency room I began to be dumb and my left leg and left arm. I could not raise either. I was given the treatment for stroke if it's within three hours and then
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-10-22
    Report sent to call center — 6 months, dose 4
    Get care from a doctor or other healthcare professional
    Hospitalization · 1 call case(s)
  46. 2022-10-25
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-01-04Moderna
22021-02-01Moderna
32021-10-28Moderna No
42022-04-23Moderna No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): My teeth are cold and hot sensitive. This is new to me. I also had chills and fever and aches yesterday.

Release 11 — days 1–6 daily, dose 4

2022-04-29

Systemic reaction (other): Very slight headache.

Release 11 — day 28, dose 4

2022-05-21

Symptoms: Had cataract surgery on Tuesday and I am experiencing double vision. My doctor says it will go away but I feel Nauseous when looking out both eyes. Probably has nothing to do with the vaccine but thought I should mention it.

Release 12 — 3 months, dose 4

2022-07-23

Symptoms: Approximately a month after I had my fourth vaccination I had cataract surgery. My left eye was done first and I developed double vision. My doctor said it was very rare it cleared up within two weeks. My second I was done two weeks later and again I cut off by CDC
Healthcare visit (other): Visits back to my eye doctor.

Release 12 — 6 months, dose 4

2022-10-22

Symptoms: I had a stroke. I am fine with no residual affects from it. While in the hospital they tested me for Covid and told me I Tested positive for Covid. I had no symptoms.
Healthcare visit (other): I was feeling a bit dizzy in the head and decided I should go to emergency while in the emergency room I began to be dumb and my left leg and left arm. I could not raise either. I was given the treatment for stroke if it's within three hours and then cut off by CDC

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

FieldPreferred term2021-092023-042024-11
HCVODizziness · · ✓
HCVOEmergency care · · ✓
HCVOMobility decreased · · ✓
HCVOOffice visit · · ✓
HCVOUnevaluable event · · ✓
SDCataract operation · · ✓
SDCataract operation complication · · ✓
SDCerebrovascular accident · · ✓
SDDiplopia · · ✓
SDHospitalisation · · ✓
SDOffice visit · · ✓
SDSARS-CoV-2 test positive · · ✓
SROChills ✓ ✓ ✓
SROHeadache · · ✓
SROHyperaesthesia teeth ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓
SROSensitivity to weather change ✓ ✓ ✓

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