3JE-15228-04029

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 038 / NH
Registered: 2021-01-10

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

2021-01-09
Dose 1 — Moderna
2021-01-10
Registered in v-safe
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Photopsia — Feeling: Good

Free text: Flashes of light in the outer corner of my left eye. No pain and I can see fine. Just weird!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Photopsia, Vitreous floaters — Feeling: Good

Free text: I reported yesterday having photopsia, flashes of light like lightening in my left eye and floaters. It was worse upon awakening so I have taken 600 mg of ibuprofen today every 5 hours. I saw improvement with that. In reading online I found an article concerning Multifocal Choroiditis following other types of vaccinations. Were there any cases of this reported by anyone else?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Photopsia, Vitreous floaters — Feeling: Good · Headache

Free text: Floaters and lightening flashes in left peripheral vision. Vaccine was in left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Moderna
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Pain, Pyrexia — Feeling: Good · Site: Pain, Itching · Fatigue or tiredness · Be unable to work

Free text: I had fatigue, fever and body aches starting 10 hours after my second vaccine. That was 5 days ago. Just a touch tired today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-09
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: TinnitusHereditary Hemochromatosis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-09
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-09
Survey response — 12 months, dose 2
MedDRA: Hereditary haemochromatosis, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with Hereditary Hemochromatosis · Healthcare visit (other): Therapeutic phlebotomies every 2 weeks. Followed by a hematologist for this.

MedDRA releases: 2024-11 · check-in free text available
2022-02-09
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-08	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-13

Systemic reaction (other): Flashes of light in the outer corner of my left eye. No pain and I can see fine. Just weird!

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): I reported yesterday having photopsia, flashes of light like lightening in my left eye and floaters. It was worse upon awakening so I have taken 600 mg of ibuprofen today every 5 hours. I saw improvement with that. In reading online I found an article concerning Multifocal Choroiditis following other types of vaccinations. Were there any cases of this reported by anyone else?

2021-01-15

Systemic reaction (other): Floaters and lightening flashes in left peripheral vision. Vaccine was in left arm.

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): I had fatigue, fever and body aches starting 10 hours after my second vaccine. That was 5 days ago. Just a touch tired today.

Release 9 — 6 months, dose 2

2021-08-09

Symptoms: TinnitusHereditary Hemochromatosis

Release 11 — 12 months, dose 2

2022-02-09

Symptoms: Diagnosed with Hereditary Hemochromatosis

Healthcare visit (other): Therapeutic phlebotomies every 2 weeks. Followed by a hematologist for this.

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	Hereditary haemochromatosis	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Tinnitus	✓	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Photopsia	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Vitreous floaters	✓	✓	✓

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