5EQ-15780-20098

Timeline

1. 2021-03-31
   Registered in v-safe
2. 2021-03-31
   Dose 1 — Moderna
3. 2021-03-31
   Survey response — day 0, dose 1

   MedDRA: Blepharospasm, Lacrimation increased, Thermal burns of eye, Vision blurred — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

   Free text: Left Eye burn, teary,and blurr vision, left eye twitching, chest lightly tide

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
4. 2021-04-01
   Survey response — days 1–6 daily, dose 1

   MedDRA: Blepharospasm — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

   Free text: Left eye twitching

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
5. 2021-04-02
   Survey response — days 1–6 daily, dose 1

   MedDRA: Blepharospasm, Cough, Pain in extremity — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Abdominal pain

   Free text: Left eye twitching, little cough, left arm of shot a bit sore/pain but mild

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
6. 2021-04-03
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · Site: Pain · Fatigue or tiredness

   Adult check-in
7. 2021-04-05
   Survey response — days 1–6 daily, dose 1

   MedDRA: Eye irritation, Pain, Periarthritis — Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

   Free text: Right shoulder locked, left eye burning and friday forgot to mention that my left upper arm was throbbing that evening.

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
8. 2021-04-06
   Survey response — days 1–6 daily, dose 1

   MedDRA: Arthralgia, Eye pruritus — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Fatigue or tiredness

   Free text: Itchy left eye, upper shoulder pain

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
9. 2021-04-07
   Survey response — day 7, dose 1

   MedDRA: Somnolence — Feeling: Good · Fatigue or tiredness

   Free text: Sleepy

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
10. 2021-04-14
    Survey response — day 14, dose 1

    MedDRA: Fatigue, Paranasal sinus discomfort — Feeling: Fair

    Free text: Sinus pressure mustly on the right side down the shoulder both side. Tired and sleept

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
11. 2021-04-21
    Health check-in — day 21, dose 1

    Feeling: Good

    Adult check-in
12. 2021-06-30
    Survey response — 3 months, dose 1

    MedDRA: Arthralgia, Blepharospasm, Condition aggravated, Insomnia, Neck pain, Pain, Pre-existing disease — Feeling: Fair

    Free text: Right shoulder hurts when lefting it in certain directions. The back of my left knee has been hurting too off and on. My neck hurts mostly on the right side. Have not been sleeping well. My left eye been twitching more than usally

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
13. 2021-10-01
    Survey response — 6 months, dose 1

    MedDRA: Ear discomfort, Ear pain, Impaired work ability — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

    Free text: Left ear is hurting since Sept 30 evening. It feels like it has something in it. It pulses which hurts. It feel stuff up too. Getting to the point where I can't work. Have doc visit on wed. Oct 5th 2021.

    MedDRA releases: 2024-11 · check-in free text available
14. 2021-10-01
    Report sent to call center — 6 months, dose 1

    Be unable to work or attend school · Get care from a doctor or other healthcare professional

    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
15. 2021-10-04
    Call successful

    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)