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
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2021-04-15
Registered in v-safe
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2021-04-15
Dose 1 — Moderna
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2021-04-15
Survey response — day 0, dose 1MedDRA: Fatigue, Injection site pain, Pre-existing disease, Vision blurred, Visual field defect — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree 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
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2021-04-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body achesAdult check-in
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2021-04-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-29
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2021-05-06
Survey response — day 21, dose 1MedDRA: Dizziness, Vertigo — Feeling: GoodFree text: Vertigo issues. Dizziness and spinning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-11
Dose 2 — Moderna
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2021-05-14
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-25
Survey response — day 14, dose 2MedDRA: Headache, Illness, Immediate post-injection reaction, Oropharyngeal pain, Pain, Vertigo, Visual impairment — Feeling: FairFree 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
- 2021-06-01
- 2021-06-08
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2021-06-15
Survey response — day 35, dose 2MedDRA: Vertigo — Feeling: GoodFree text: Vertigo againMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-22
Survey response — day 42, dose 2MedDRA: Vertigo — Feeling: GoodFree text: Still have vertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-11 | Moderna |
Free text
Release 7 — day 0, dose 1
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
Symptoms: Vertigo issues. Dizziness and spinning.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Sore throat
Release 8 — day 14, dose 2
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
Symptoms: Vertigo again
Release 9 — day 42, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Illness | ✓ | ✓ | ✓ |
| SD | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SD | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Visual field defect | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release