3YP-69315-70827
2 vaccinations
7 coded responses
23 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 640 / MO
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Registered in v-safe
-
2021-01-07
Dose 1 — Moderna
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-13
- 2021-01-16
- 2021-01-22
- 2021-01-28
-
2021-02-04
Dose 2 — Moderna
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: All are mild symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-07
-
2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Disturbance in attention — Feeling: Good · Fatigue or tirednessFree text: Difficulty concentratingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-09
Survey response — days 1–6 daily, dose 2MedDRA: Disturbance in attention — Feeling: Good · Fatigue or tirednessFree text: Difficulty concentrating on workMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — day 7, dose 2MedDRA: Headache — Feeling: GoodFree text: Significant headache Tuesday through Wednesday morning. Gone by 10 am Wednesday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
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2021-02-27
Survey response — day 21, dose 2MedDRA: Retinal detachment — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Small retinal detachment.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-04
Survey response — day 28, dose 2MedDRA: Dizziness, Medical observation, Pre-existing disease, Vitreous floaters — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Retinal detachment caused a floater in left eye. Today it moved toward the center of my field of vision. I got really dizzy twice. I have been to the eye doctor 2 times in two weeks. · Healthcare visit (other): Eye examMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Report sent to call center — day 28, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-18
-
2021-05-06
Survey response — 3 months, dose 2MedDRA: Office visit, Vitreous detachment — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I was mistaken last time. It is not a retinnal detachment. I have experienced a posterior vitreous detachment.Other than that I'm ok. · Healthcare visit (other): Several visits yo an ophthalmologist to monitor my condition.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-06
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-17
Call successfulParticipant prefers to complete VAERS report online
- 2021-08-09
- 2022-02-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): All are mild symptoms.
Systemic reaction (other): Difficulty concentrating
Systemic reaction (other): Difficulty concentrating on work
Release 4 — day 7, dose 2
Systemic reaction (other): Significant headache Tuesday through Wednesday morning. Gone by 10 am Wednesday.
Release 4 — day 21, dose 2
Symptoms: Small retinal detachment.
Release 5 — day 28, dose 2
Symptoms: Retinal detachment caused a floater in left eye. Today it moved toward the center of my field of vision. I got really dizzy twice. I have been to the eye doctor 2 times in two weeks.
Healthcare visit (other): Eye exam
Release 8 — 3 months, dose 2
Symptoms: I was mistaken last time. It is not a retinnal detachment. I have experienced a posterior vitreous detachment.Other than that I'm ok.
Healthcare visit (other): Several visits yo an ophthalmologist to monitor my condition.
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 | Medical observation | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Retinal detachment | ✓ | ✓ | ✓ |
| SD | Vitreous detachment | ✓ | ✓ | ✓ |
| SD | Vitreous floaters | ✓ | ✓ | ✓ |
| SRO | Disturbance in attention | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release