6FN-47610-24399
2 vaccinations
4 coded responses
9 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 015 / MA
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-16
Registered in v-safe
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2021-01-16
Survey response — day 7, dose 1MedDRA: Visual impairment — Feeling: Good · Site: PainFree text: Left eye started to show a change in vision looking at lights , started second day after injection. Instead of seeing round circle lights at night, round light bulbs look like a star at night with long tail coming from round light on top and bottom of lightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Pain in extremity, Visual impairment — Feeling: GoodFree text: Left foot pain, persistent left eye change in vision with streaks coming from lights but no change in day visionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-05
Dose 2 — Moderna
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Left foot pain affecting plantar fasciaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2021-02-19
- 2021-03-06
- 2021-03-21
- 2021-05-09
-
2021-08-06
Survey response — 6 months, dose 2MedDRA: Arthralgia, Neck pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Neck pain, joint painMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-06
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-22
-
2021-11-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): Left eye started to show a change in vision looking at lights , started second day after injection. Instead of seeing round circle lights at night, round light bulbs look like a star at night with long tail coming from round light on top and bottom of light
Release 2 — day 14, dose 1
Symptoms: Left foot pain, persistent left eye change in vision with streaks coming from lights but no change in day vision
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Left foot pain affecting plantar fascia
Release 9 — 6 months, dose 2
Symptoms: Neck pain, joint pain
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 | Arthralgia | ✓ | · | ✓ |
| SD | Neck pain | ✓ | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release