379-27320-69849

2 vaccinations 9 coded responses 12 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 088 / NJ
Registered: 2021-04-20

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

2021-04-20
Registered in v-safe
2021-04-20
Dose 1 — Moderna
2021-04-20
Survey response — day 0, dose 1
MedDRA: Dizziness, Paraesthesia oral — Feeling: Good · Fatigue or tiredness

Free text: Tingling in mouth dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itchy face for past couple days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-27
Survey response — day 7, dose 1
MedDRA: Pain in extremity — Feeling: Good · Fatigue or tiredness

Free text: I had to get a cortisone shot in my foot so hope it didn't screw up the study. Had no chiice because of the amount if pain i was in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 21, dose 1
MedDRA: Office visit, Vitreous floaters — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have flashing lights and a big floater in my left eye. It occurred a week or so after I bumped my face on a chair, so I think it is due to the accident not the vaccine. I am having my second Moderna dose next week · Healthcare visit (other): Eye doctor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-18
Dose 2 — Moderna
2021-05-27
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-06-10
Survey response — day 21, dose 2
MedDRA: Office visit, Photopsia, Vitreous floaters — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Flashers and floaters in both eyes · Healthcare visit (other): Optician

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Survey response — day 28, dose 2
MedDRA: Eye pain, Vitreous floaters — Feeling: Fair · Be unable to do your normal daily activities

Free text: Floaters and flashers in right eye now as well as left eye. Pain in right eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Call 1 — Left Voicemail
2021-06-22
Survey response — day 35, dose 2
MedDRA: Headache, Photopsia, Vitreous floaters — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increase in floaters/flashers headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-17
Survey response — 3 months, dose 2
MedDRA: Dry eye, Photopsia, Visual impairment, Vitreous floaters — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Severe dry eye temporary loss of peripheral vision. Still have floaters and flashers

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-20
Call 1 — Left Voicemail
2022-05-18
Survey response — 12 months, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chronic cough

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-20	Moderna
2	2021-05-18	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 7 — day 0, dose 1

2021-04-20

Systemic reaction (other): Tingling in mouth dizzy

Release 7 — days 1–6 daily, dose 1

2021-04-22

Systemic reaction (other): Itchy face for past couple days

Release 8 — day 7, dose 1

2021-04-27

Systemic reaction (other): I had to get a cortisone shot in my foot so hope it didn't screw up the study. Had no chiice because of the amount if pain i was in.

Release 8 — day 21, dose 1

2021-05-14

Symptoms: I have flashing lights and a big floater in my left eye. It occurred a week or so after I bumped my face on a chair, so I think it is due to the accident not the vaccine. I am having my second Moderna dose next week

Healthcare visit (other): Eye doctor visit

Release 9 — day 21, dose 2

2021-06-10

Symptoms: Flashers and floaters in both eyes

Healthcare visit (other): Optician

Release 9 — day 28, dose 2

2021-06-15

Symptoms: Floaters and flashers in right eye now as well as left eye. Pain in right eye

Release 9 — day 35, dose 2

2021-06-22

Symptoms: Increase in floaters/flashers headache

Release 9 — 3 months, dose 2

2021-08-17

Symptoms: Severe dry eye temporary loss of peripheral vision. Still have floaters and flashers

Release 11 — 12 months, dose 2

2022-05-18

Symptoms: Chronic cough

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	Office visit	✓	✓	✓
SD	Dry eye	✓	·	✓
SD	Eye pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Photopsia	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Visual impairment	✓	·	✓
SD	Vitreous floaters	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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