485-21701-74488
2 vaccinations
10 coded responses
24 check-ins
10 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 928 / CA
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- Other
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-30
Registered in v-safe
-
2021-01-30
Dose 1 — Moderna
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
-
2021-02-27
Dose 2 — Moderna
-
2021-02-27
Survey response — day 0, dose 2MedDRA: Vision blurred — Feeling: GoodFree text: Little blurry vision in both eyes outdoors in Sun lightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Vitreous floaters — Feeling: GoodFree text: Floaters inside of Left eye.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Vision blurred, Vitreous floaters — Feeling: GoodFree text: Clouded vision left eye. FloatersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Vision blurred — Feeling: GoodFree text: Clouded vision in Left eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Ocular discomfort, Vision blurred — Feeling: GoodFree text: Still have blurred vision in left eye and pressure.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Vision blurred — Feeling: Good · Fatigue or tirednessFree text: Blurred vision left eye...MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Vision blurred — Feeling: Good · Fatigue or tirednessFree text: Blurred vision of the Left eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Survey response — day 7, dose 2MedDRA: Vision blurred — Feeling: GoodFree text: Blurred vision of the left eye stillMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-20
-
2021-03-27
Survey response — day 28, dose 2MedDRA: Office visit, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Right eye vision is still blurred and fussy!! · Healthcare visit (other): Visit Eye Doctor. Ask about conditions.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-27
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-03
Survey response — day 35, dose 2MedDRA: Vision blurred — Feeling: GoodFree text: Still have blurred vision in left eye!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-05-29
-
2022-01-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): Little blurry vision in both eyes outdoors in Sun light
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Floaters inside of Left eye.
Systemic reaction (other): Clouded vision left eye. Floaters
Systemic reaction (other): Clouded vision in Left eye
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Still have blurred vision in left eye and pressure.
Systemic reaction (other): Blurred vision left eye...
Systemic reaction (other): Blurred vision of the Left eye
Release 5 — day 7, dose 2
Systemic reaction (other): Blurred vision of the left eye still
Release 6 — day 28, dose 2
Symptoms: Right eye vision is still blurred and fussy!!
Healthcare visit (other): Visit Eye Doctor. Ask about conditions.
Release 6 — day 35, dose 2
Symptoms: Still have blurred vision in left eye!!
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 | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Ocular discomfort | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Vitreous floaters | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release