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5EN-13549-56523

2 vaccinations 6 coded responses 15 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
890 / NV
Registered
2021-04-15
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-15
    Registered in v-safe
  2. 2021-04-15
    Dose 1 — Moderna
  3. 2021-04-15
    Survey response — day 0, dose 1
    MedDRA: Fatigue, Injection site pain, Pre-existing disease, Vision blurred, Visual field defect — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: about 20 minutes after the shot I had already left the vaccination site after the 15 minute observation period and, I began to have weird blurriness and prism like visions in both eyes but mainly the right eye. The peripheral in my right eye went blurry as I couldn't see my mom sitting to the right of me. I kept testing my peripheral on both sides and the left eye was fine but the right eye was blurry. The prism shapes continued like wavelengths waving around in my right eye. After about 25 minutes, the prisms disappeared and my peripheral vision came back. What is up with that??? It's been about 6 hours now and my left arm injection site is getting more and more soar. I am moving my arm around to keep the muscle area active. My headaches come and go. Feeling a bit tired.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches
    Adult check-in
  5. 2021-04-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  6. 2021-04-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-04-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-04-22
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Swelling, Itching · None
    Adult check-in
  10. 2021-04-29
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-05-06
    Survey response — day 21, dose 1
    MedDRA: Dizziness, Vertigo — Feeling: Good
    Free text: Vertigo issues. Dizziness and spinning.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-11
    Dose 2 — Moderna
  13. 2021-05-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-25
    Survey response — day 14, dose 2
    MedDRA: Headache, Illness, Immediate post-injection reaction, Oropharyngeal pain, Pain, Vertigo, Visual impairment — Feeling: Fair
    Free text: 20-25 minutes after second shot I started seeing sparkles/stars right side vision. Lasted about 10 minutes. Later that night developed sore throat, headaches and body aches. Was sick for 2 days straight. Now I have had vertigo issues for 4 days.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-06-01
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-06-08
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-06-15
    Survey response — day 35, dose 2
    MedDRA: Vertigo — Feeling: Good
    Free text: Vertigo again
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-06-22
    Survey response — day 42, dose 2
    MedDRA: Vertigo — Feeling: Good
    Free text: Still have vertigo
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-04-15Moderna
22021-05-11Moderna

Free text

Release 7 — day 0, dose 1

2021-04-15

Systemic reaction (other): about 20 minutes after the shot I had already left the vaccination site after the 15 minute observation period and, I began to have weird blurriness and prism like visions in both eyes but mainly the right eye. The peripheral in my right eye went blurry as I couldn't see my mom sitting to the right of me. I kept testing my peripheral on both sides and the left eye was fine but the right eye was blurry. The prism shapes continued like wavelengths waving around in my right eye. After about 25 minutes, the prisms disappeared and my peripheral vision came back. What is up with that??? It's been about 6 hours now and my left arm injection site is getting more and more soar. I am moving my arm around to keep the muscle area active. My headaches come and go. Feeling a bit tired.

Release 8 — day 21, dose 1

2021-05-06

Symptoms: Vertigo issues. Dizziness and spinning.

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Sore throat

Release 8 — day 14, dose 2

2021-05-25

Symptoms: 20-25 minutes after second shot I started seeing sparkles/stars right side vision. Lasted about 10 minutes. Later that night developed sore throat, headaches and body aches. Was sick for 2 days straight. Now I have had vertigo issues for 4 days.

Release 9 — day 35, dose 2

2021-06-15

Symptoms: Vertigo again

Release 9 — day 42, dose 2

2021-06-22

Symptoms: Still have vertigo

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

FieldPreferred term2021-092023-042024-11
SDDizziness ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDIllness ✓ ✓ ✓
SDImmediate post-injection reaction ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDVertigo ✓ ✓ ✓
SDVisual impairment ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROVision blurred ✓ ✓ ✓
SROVisual field defect ✓ ✓ ✓

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