59J-19409-45554

3 vaccinations 9 coded responses 27 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 983 / WA
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site mass, Injection site pain — Feeling: Fair · Site: Pain, Redness, Swelling

Free text: I'm fine but the injection site is pretty sore and there's a large, hard lump. 1 1/â€œx1â€ approximately

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site inflammation, Injection site nodule — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Large inflamed, hard, red spot at injection site. Only slightly tender.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: A muscle in the front of my lower left leg is spasming horribly to the point I can hardly walk.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal sensation in eye, Aphasia, Confusional state, Medical counselling, Pre-existing disease, Vision blurred — Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Mild Confusion, struggle finding correct words periodically. Main more intense problem today is with my eyes. Blurry vision, both near and far, with and without glasses on. I have 20/15 vision and wear glasses to correct astigmatism and for reading. Right eye feels strange. · Healthcare visit (other): Ive called my optometrist who is monitoring the situation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Vision blurred — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Yesterday my eyesight was blurry all day, with and without my glasses on. Better today. · Healthcare visit (other): I called my ophthalmologist. He recommended monitoring it for a day or two and was going to have me come in if it wasnt better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-03-30
Call 1 — Left Voicemail
2021-05-09
Survey response — 3 months, dose 2
MedDRA: Visual impairment — Feeling: Fair

Free text: Vision problems off and on since 3 days after second vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-24
Call 1 — Left Voicemail
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Eye disorder, Unevaluable event, Vision blurred — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Still having issues with eyes. Often blurry with and without my glasses. Started after second dose of Moderna. · Healthcare visit (other): I called theologies and he monitored it over a few days. I never did go in and am considering scheduling an appointment.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-09-03
Dose 3 — Moderna
2021-12-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-04
Survey response — 6 months, dose 3
MedDRA: Cough, Fatigue, Headache, Nasal congestion, Nasopharyngitis, Office visit, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Some sort of head cold, headache, nasal congestion, cough, fatigue. 3 rapid tests and one PCR from local hospital were all negative for Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-09-03
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I got Covid in April, 2022. Did antivirals and doing fine now.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-09-03	Moderna	No

Call center

4 call center cases

4 successful

VAERS report filed, before or during a call: 4

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): I'm fine but the injection site is pretty sore and there's a large, hard lump. 1 1/â€œx1â€ approximately

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Large inflamed, hard, red spot at injection site. Only slightly tender.

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): A muscle in the front of my lower left leg is spasming horribly to the point I can hardly walk.

2021-02-08

Systemic reaction (other): Mild Confusion, struggle finding correct words periodically. Main more intense problem today is with my eyes. Blurry vision, both near and far, with and without glasses on. I have 20/15 vision and wear glasses to correct astigmatism and for reading. Right eye feels strange.

Healthcare visit (other): Ive called my optometrist who is monitoring the situation.

2021-02-09

Systemic reaction (other): Yesterday my eyesight was blurry all day, with and without my glasses on. Better today.

Healthcare visit (other): I called my ophthalmologist. He recommended monitoring it for a day or two and was going to have me come in if it wasnt better.

Release 8 — 3 months, dose 2

2021-05-09

Symptoms: Vision problems off and on since 3 days after second vaccination.

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Still having issues with eyes. Often blurry with and without my glasses. Started after second dose of Moderna.

Healthcare visit (other): I called theologies and he monitored it over a few days. I never did go in and am considering scheduling an appointment.

Release 11 — 6 months, dose 3

2022-03-04

Symptoms: Some sort of head cold, headache, nasal congestion, cough, fatigue. 3 rapid tests and one PCR from local hospital were all negative for Covid.

Release 12 — 12 months, dose 3

2022-09-03

Symptoms: I got Covid in April, 2022. Did antivirals and doing fine now.

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 counselling	✓	✓	✓
HCVO	Unevaluable event	✓	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Eye disorder	✓	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site inflammation	✓	✓	✓
SD	Injection site nodule	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Office visit	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vision blurred	✓	·	✓
SD	Visual impairment	✓	✓	✓
SRO	Abnormal sensation in eye	✓	·	✓
SRO	Aphasia	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Injection site induration	○	○	○
SRO	Injection site mass	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Vision blurred	✓	✓	✓

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