4PP-14888-50614

2 vaccinations 7 coded responses 16 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 836 / ID
Registered: 2021-04-26

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-26
Registered in v-safe
2021-04-26
Dose 1 — Moderna
2021-04-26
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 1
MedDRA: Corrective lens user, Vision blurred — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Blurred vision since 4272021 makes it difficult to see close up or far away objects and words. I wear glasses for near sightedness. Now wearing them is futile.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 1
MedDRA: Diplopia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Double vision has improved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 1
MedDRA: Ocular discomfort — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eye discomfort. Seeping. At corners. Feels as if there is debris, dust in my eyes. I do not rub them or touch them. Follow your guidlines for covid 19 safety.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-03
Survey response — day 7, dose 1
MedDRA: Foreign body sensation in eyes, Lacrimation increased — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eyes are still seeping. Feels as if debris ir material is in my eyes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-17
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-24
Dose 2 — Moderna
2021-06-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-30
Survey response — day 35, dose 2
MedDRA: Arthralgia, Fatigue, Headache, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain, muscle pain, headaches, fatigued.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-05
Survey response — day 42, dose 2
MedDRA: Ocular hyperaemia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Both of my eyes seep at both interior and exterior corners. It causes bleeding like a bit sand is trapped. Interferes with clear vision.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-24
Survey response — 3 months, dose 2
MedDRA: Brain fog, Communication disorder, Depressed level of consciousness, Disturbance in attention, Dizziness, Dyslexia, Ear discomfort, Gait disturbance, Headache, Memory impairment, Nasal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches, Nasal and ear discomfort. Dizziness, off balance with my gait. Brain foggy not as alert as I was before 2nd dose. Focus and attention span affected. Short term memory considerably diminished. Spelling difficult and comprehending verbal ..

MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-26	Moderna
2	2021-05-24	Moderna

Free text

Release 8 — days 1–6 daily, dose 1

2021-04-28

Systemic reaction (other): Blurred vision since 4272021 makes it difficult to see close up or far away objects and words. I wear glasses for near sightedness. Now wearing them is futile.

2021-04-29

Systemic reaction (other): Double vision has improved.

2021-05-01

Systemic reaction (other): Eye discomfort. Seeping. At corners. Feels as if there is debris, dust in my eyes. I do not rub them or touch them. Follow your guidlines for covid 19 safety.

Release 8 — day 7, dose 1

2021-05-03

Systemic reaction (other): Eyes are still seeping. Feels as if debris ir material is in my eyes.

Release 9 — day 35, dose 2

2021-06-30

Symptoms: Joint pain, muscle pain, headaches, fatigued.

Release 9 — day 42, dose 2

2021-07-05

Symptoms: Both of my eyes seep at both interior and exterior corners. It causes bleeding like a bit sand is trapped. Interferes with clear vision.

Release 9 — 3 months, dose 2

2021-08-24

Symptoms: Headaches, Nasal and ear discomfort. Dizziness, off balance with my gait. Brain foggy not as alert as I was before 2nd dose. Focus and attention span affected. Short term memory considerably diminished. Spelling difficult and comprehending verbal .. cut off by CDC

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	Arthralgia	✓	✓	✓
SD	Brain fog	✓	·	✓
SD	Communication disorder	✓	·	✓
SD	Depressed level of consciousness	✓	·	✓
SD	Disturbance in attention	✓	·	✓
SD	Dizziness	✓	·	✓
SD	Dyslexia	✓	·	✓
SD	Ear discomfort	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Gait disturbance	✓	·	✓
SD	Headache	✓	✓	✓
SD	Memory impairment	✓	·	✓
SD	Myalgia	✓	✓	✓
SD	Nasal discomfort	✓	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SRO	Corrective lens user	✓	✓	✓
SRO	Diplopia	✓	✓	✓
SRO	Foreign body sensation in eyes	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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