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69U-14234-81418

2 vaccinations 9 coded responses 24 check-ins 9 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
287 / NC
Registered
2021-01-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-22
    Registered in v-safe
  2. 2021-01-22
    Dose 1 — Moderna
  3. 2021-01-22
    Survey response — day 0, dose 1
    MedDRA: Pruritus — Feeling: Good · Chills, Fatigue or tiredness
    Free text: Slight itching about 3 hours after shot. On face and back. No rash or hives or splotchiness.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-24
    Survey response — days 1–6 daily, dose 1
    MedDRA: Ocular hyperaemia — Feeling: Good
    Free text: At the end of day of shot a bloodshot eye developed. It is back to normal today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-28
    Survey response — days 1–6 daily, dose 1
    MedDRA: Visual impairment — Feeling: Fair · Headache · Be unable to do your normal daily activities
    Free text: Vision is not real good today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-29
    Survey response — day 7, dose 1
    MedDRA: Feeling cold, Visual impairment — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Feel cold but not chills. Still have some issues with vision.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-05
    Survey response — day 14, dose 1
    MedDRA: Injection site mass — Feeling: Fair
    Free text: It isn't new but I have noticed that I still have a knot or lump where the needle went in to my arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-12
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-19
    Dose 2 — Moderna
  13. 2021-02-19
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  14. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling · None
    Adult check-in
  18. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-26
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-05
    Survey response — day 14, dose 2
    MedDRA: Fatigue, Headache — Feeling: Fair
    Free text: Headache and tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-03-12
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-19
    Survey response — day 28, dose 2
    MedDRA: Abdominal discomfort, Headache, Malaise, Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Generally feel lousy. Headache, upset stomach, sore throat, sinus drainage. Should not be related to Civid vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-03-26
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-02
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-21
    Survey response — 3 months, dose 2
    MedDRA: Cerebrovascular accident — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Had a stroke
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-05-21
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  28. 2021-08-20
    Survey response — 6 months, dose 2
    MedDRA: Cough, Paranasal sinus hypersecretion, Unevaluable event, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Vision is not as goid as it was a month or so ago. Also have bad sinus drainage and cougg · Healthcare visit (other): Will see opthamologist in Oct . Will gi to walkin clinic within the next few days for sunus and cough
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  29. 2021-08-20
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  30. 2021-08-23

Vaccinations

DoseDateManufacturerCo-administered
12021-01-22Moderna
22021-02-19Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-22

Systemic reaction (other): Slight itching about 3 hours after shot. On face and back. No rash or hives or splotchiness.

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): At the end of day of shot a bloodshot eye developed. It is back to normal today.

2021-01-28

Systemic reaction (other): Vision is not real good today

Release 3 — day 7, dose 1

2021-01-29

Systemic reaction (other): Feel cold but not chills. Still have some issues with vision.

Release 3 — day 14, dose 1

2021-02-05

Symptoms: It isn't new but I have noticed that I still have a knot or lump where the needle went in to my arm

Release 5 — day 14, dose 2

2021-03-05

Symptoms: Headache and tired

Release 5 — day 28, dose 2

2021-03-19

Symptoms: Generally feel lousy. Headache, upset stomach, sore throat, sinus drainage. Should not be related to Civid vaccine

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Had a stroke

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Vision is not as goid as it was a month or so ago. Also have bad sinus drainage and cougg
Healthcare visit (other): Will see opthamologist in Oct . Will gi to walkin clinic within the next few days for sunus and cough

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
HCVOCough ✓ · ✓
HCVOUnevaluable event ✓ · ✓
SDAbdominal discomfort ✓ ✓ ✓
SDCerebrovascular accident ✓ ✓ ✓
SDCough ✓ · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInjection site mass ✓ ✓ ✓
SDMalaise ✓ · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDParanasal sinus hypersecretion ✓ · ✓
SDVisual impairment ✓ · ✓
SROFeeling cold ✓ ✓ ✓
SROOcular hyperaemia ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROVisual impairment ✓ ✓ ✓

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

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