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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

  1. 2021-01-08
    Dose 1 — Moderna
  2. 2021-01-16
    Registered in v-safe
  3. 2021-01-16
    Survey response — day 7, dose 1
    MedDRA: Visual impairment — Feeling: Good · Site: Pain
    Free 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 light
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-22
    Survey response — day 14, dose 1
    MedDRA: Pain in extremity, Visual impairment — Feeling: Good
    Free text: Left foot pain, persistent left eye change in vision with streaks coming from lights but no change in day vision
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-05
    Dose 2 — Moderna
  6. 2021-02-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 activities
    Free text: Left foot pain affecting plantar fascia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Joint pains, Muscle or body aches
    Adult check-in
  8. 2021-02-19
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-03-06
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-03-21
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-05-09
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-08-06
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Neck pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Neck pain, joint pain
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  13. 2021-08-06
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-11-22
  15. 2021-11-22
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-01-08Moderna
22021-02-05Moderna

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-16

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

2021-01-22

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

2021-02-07

Systemic reaction (other): Left foot pain affecting plantar fascia

Release 9 — 6 months, dose 2

2021-08-06

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ · ✓
SDNeck pain ✓ · ✓
SDPain in extremity ✓ ✓ ✓
SDVisual impairment ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROVisual impairment ✓ ✓ ✓

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