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
-
2021-01-04
Registered in v-safe
-
2021-01-04
Dose 1 — Moderna
- 2021-01-04
-
2021-01-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-13
- 2021-01-18
- 2021-01-25
-
2021-02-01
Dose 2 — Moderna
-
2021-02-03
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Hyperaesthesia teeth, Pain, Pyrexia, Sensitivity to weather change — Feeling: Fair · Fatigue or tirednessFree 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
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-05-03
- 2021-08-02
-
2021-10-28
Dose 3 — Moderna
- 2022-02-01
- 2022-02-01
-
2022-04-23
Dose 4 — Moderna
- 2022-04-26
- 2022-04-27
- 2022-04-28
-
2022-04-29
Survey response — days 1–6 daily, dose 4MedDRA: Headache — Feeling: Fair · HeadacheFree text: Very slight headache.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-30
- 2022-05-07
- 2022-05-14
-
2022-05-21
Survey response — day 28, dose 4MedDRA: Cataract operation complication, Office visit — Feeling: Fair · Be unable to work or attend schoolFree 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
- 2022-05-28
- 2022-06-04
-
2022-07-23
Survey response — 3 months, dose 4MedDRA: Cataract operation, Diplopia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree 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
-
2022-07-23
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-07-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-22
Survey response — 6 months, dose 4MedDRA: 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 · HospitalizationFree 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 thenMedDRA releases: 2024-11 · check-in free text available
-
2022-10-22
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-10-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-01 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-23 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 2
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
Systemic reaction (other): Very slight headache.
Release 11 — day 28, dose 4
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Dizziness | · | · | ✓ |
| HCVO | Emergency care | · | · | ✓ |
| HCVO | Mobility decreased | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Cataract operation | · | · | ✓ |
| SD | Cataract operation complication | · | · | ✓ |
| SD | Cerebrovascular accident | · | · | ✓ |
| SD | Diplopia | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Hyperaesthesia teeth | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Sensitivity to weather change | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release