49P-14295-19721
4 vaccinations
4 coded responses
25 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 970 / OR
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Registered in v-safe
-
2021-01-17
Dose 1 — Moderna
-
2021-01-17
Health check-in — day 0, dose 1Feeling: Good · Site: Swelling · Muscle or body achesAdult check-in
- 2021-01-18
- 2021-01-19
-
2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Muscle or body achesAdult check-in
- 2021-01-22
- 2021-01-23
-
2021-01-24
Survey response — day 7, dose 1MedDRA: Medical counselling, Photopsia, Visual field defect, Visual impairment, Vitreous disorder — Feeling: Good · HeadacheFree text: Yesterday right after I sent in the report I had a first time symptom with my eyes . My vision got weird and I was seeing triangular shapes and flashing lights in my perfrifel vision called eye doc and he said most likely a random symptom of vitreousis. Eyes seem fine today. Will get checked tomorrow. No headache. Or high blood pressure.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
-
2021-02-07
Survey response — day 21, dose 1MedDRA: Injection site reaction, Rash erythematous, Rash pruritic, Tenderness — Feeling: GoodFree text: Large oblong red looking melted rash on and around upper arm injection site. Very itchy for two days with tendernessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
-
2021-02-21
Dose 2 — Moderna
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-05-23
- 2021-08-22
- 2022-02-21
-
2022-04-12
Dose 3 — Moderna
-
2022-04-23
Dose 4 — Moderna
-
2022-04-23
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Moderna | |
| 2 | 2021-02-21 | Moderna | |
| 3 | 2022-04-12 | Moderna | No |
| 4 | 2022-04-23 | Moderna | No |
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): Yesterday right after I sent in the report I had a first time symptom with my eyes . My vision got weird and I was seeing triangular shapes and flashing lights in my perfrifel vision called eye doc and he said most likely a random symptom of vitreousis. Eyes seem fine today. Will get checked tomorrow. No headache. Or high blood pressure.
Release 3 — day 21, dose 1
Symptoms: Large oblong red looking melted rash on and around upper arm injection site. Very itchy for two days with tenderness
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): No
Release 11 — day 0, dose 4
Systemic reaction (other): None
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 |
|---|---|---|---|---|
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Tenderness | ✓ | ✓ | ✓ |
| SRO | Medical counselling | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Photopsia | ✓ | ✓ | ✓ |
| SRO | Visual field defect | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Vitreous disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release