6LT-25417-59032
5 vaccinations
38 coded responses
64 check-ins
37 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 287 / NC
- Registered
- 2020-12-22
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
M7U-27856-06316
Adult relative or friend · Female · 2021-11-24
Timeline
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2020-12-22
Registered in v-safe
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2020-12-22
Dose 1 — Moderna
- 2020-12-22
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2020-12-23
Survey response — days 1–6 daily, dose 1MedDRA: Dry eye, Tinnitus, Vision blurred — Feeling: Good · Site: Pain · Joint painsFree text: Had transient ringing after 5 hours left ear 9/10, lasted for 45 seconds, and dry eyes and blurred vision lasted for 7 hours. Nothing this morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2020-12-24
Survey response — days 1–6 daily, dose 1MedDRA: Head discomfort — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Heavyness of headMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-25
- 2020-12-26
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2020-12-27
Survey response — days 1–6 daily, dose 1MedDRA: Vision blurred — Feeling: GoodFree text: Blurred vision all day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-28
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2020-12-29
Survey response — day 7, dose 1MedDRA: Neck pain — Feeling: Good · HeadacheFree text: Neck pain/ global and temporal regionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-06
Survey response — day 14, dose 1MedDRA: Back pain, Chills, Headache, Malaise, Neck pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Severe neck and back pain followed by headache and general malaise. No fever . But chills. No COVID-19 tested.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-06
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-12
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2021-01-19
Dose 2 — Moderna
- 2021-01-19
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2021-01-20
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Hallucination, Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to workFree text: Hallucinations from high temperaturesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-21
Survey response — days 1–6 daily, dose 2MedDRA: Ear pain, Musculoskeletal chest pain, Neck pain — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Ear aches, neck pain, Ribs pain when taking a deep breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-22
Survey response — days 1–6 daily, dose 2MedDRA: Balance disorder, Ear pain, Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Mental fog, ear aches, some balance issues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Survey response — days 1–6 daily, dose 2MedDRA: Costochondritis, Dyspnoea, Ear pain — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Costochondritis, difficult in taking deep breath. Left ear acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Glossitis — Feeling: Fair · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Loss of appetite, glossitisMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Ear pain, Neck pain, Pruritus — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Ears and neck, back aches. Itching around the umbilical regionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Survey response — day 7, dose 2MedDRA: Ear pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Ear achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-09
- 2021-02-16
- 2021-03-02
- 2021-04-20
- 2021-07-20
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2021-11-22
Dose 3 — Moderna
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2021-11-24
Survey response — days 1–6 daily, dose 3MedDRA: Decreased appetite, Disturbance in attention, Ear congestion, Eye pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend schoolFree text: Loss of appetite, eye pain, stuffy ears, lack of concentrationMedDRA releases: 2024-11 · check-in free text available
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2021-11-25
Survey response — days 1–6 daily, dose 3MedDRA: Brain fog, Disturbance in attention, Ear discomfort, Eye pain, Hyperacusis, Malaise, Memory impairment, Photophobia — Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Stuffed left ear, brain fog, General malaise, orbital pain, sensitivity to sound and light, unable to focus and retainMedDRA releases: 2024-11 · check-in free text available
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2021-11-26
Survey response — days 1–6 daily, dose 3MedDRA: Brain fog, Disturbance in attention, Eye pain, Hypoacusis, Malaise — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolFree text: Left ear less hearing, orbital pain , brain fog, generalized malaise, inability to focusMedDRA releases: 2024-11 · check-in free text available
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2021-11-27
Survey response — days 1–6 daily, dose 3MedDRA: Arthralgia, Brain fog, Decreased appetite, Ear discomfort, Rash, Spinal pain — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Stuffed left year, brain fog, mid back spinal column pain, shoulder pain, nares rash, loss of appetiteMedDRA releases: 2024-11 · check-in free text available
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2021-11-28
Survey response — days 1–6 daily, dose 3MedDRA: Anger, Brain fog, Hyperacusis, Malaise, Photophobia — Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Anger-response to light and sound, brain fog, malaiseMedDRA releases: 2024-11 · check-in free text available
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2021-11-29
Survey response — day 7, dose 3MedDRA: Brain fog, Disturbance in attention, Eye pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Brain fog, sense of no interest, can't focus. Orbital pain to touch.MedDRA releases: 2024-11 · check-in free text available
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2021-12-06
Survey response — day 14, dose 3MedDRA: Apathy, Brain fog, Eye irritation, Fatigue — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Tired, brain fog, eyes burning, not motivatedMedDRA releases: 2024-11 · check-in free text available
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2021-12-13
Survey response — day 21, dose 3MedDRA: Brain fog, Depression — Feeling: Good · Be unable to do your normal daily activitiesFree text: Brain fogging, depressionMedDRA releases: 2024-11 · check-in free text available
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2021-12-20
Survey response — day 28, dose 3MedDRA: Abdominal pain upper, Noninfective gingivitis, Pain, Ulcer, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Gastric pain, maybe ulcer, and left lower molar gum inflammation started after booster dose slowly from soreness to ulcers. Still have it. Never had ulcers in the past 67 years!MedDRA releases: 2024-11 · check-in free text available
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2021-12-27
Survey response — day 35, dose 3MedDRA: Abdominal pain upper, Apathy, Decreased appetite, Gastrointestinal ulcer — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Upper abdominal pain, ulcers, taking antacids for 14 days plan and get upper endoscopy done. Loss of appetite. Lack of motivation.MedDRA releases: 2024-11 · check-in free text available
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2022-01-03
Survey response — day 42, dose 3MedDRA: Abdominal pain, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Tummy aches and on Prilosec OTC. Still hurtsMedDRA releases: 2024-11 · check-in free text available
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2022-01-03
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-04
- 2022-01-07
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2022-02-21
Survey response — 3 months, dose 3MedDRA: Abdominal distension, Abdominal pain upper, Emergency care, Gastric ulcer — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Gastric ulcers, upper abdominal pain, 15 days treatment with Prilosec. Bloating · Healthcare visit (other): At the hospital consultation with a gastroenterologistMedDRA releases: 2024-11 · check-in free text available
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2022-02-21
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-23
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2022-05-20
Dose 4 — Moderna
- 2022-05-20
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2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-05-22
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog, Irritability, Periorbital pain, Photophobia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Periorbital pain, photophobia, brain fog, irritabilityMedDRA releases: 2024-11 · check-in free text available
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2022-05-23
Survey response — days 1–6 daily, dose 4MedDRA: Decreased appetite, Periorbital pain, Photophobia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Loss of appetite, peri orbital pain, photophobiaMedDRA releases: 2024-11 · check-in free text available
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2022-05-24
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog, Decreased appetite, Disturbance in attention, Irritability — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Brain fog, no appetite, irritability, low concentrationMedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Survey response — days 1–6 daily, dose 4MedDRA: Arthralgia, Brain fog, Disturbance in attention, Ear pain, Neck pain, Pain in jaw — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Brain fog, less concentration. Ear and jaw pain, neck pain, shouldersMedDRA releases: 2024-11 · check-in free text available
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2022-05-26
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog, Disturbance in attention, Periorbital pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Peri orbital pain, inability to concentrate, brain fogMedDRA releases: 2024-11 · check-in free text available
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2022-05-27
Survey response — day 7, dose 4MedDRA: Arthralgia, Brain fog, Periorbital pain, Photophobia — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Brain fog, joint pain, and periorbital pain, some photophobiaMedDRA releases: 2024-11 · check-in free text available
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-03
- 2022-08-19
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2022-11-30
Dose 5 — ModernaCo-administered: Flu
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2022-12-01
Survey response — days 1–6 daily, dose 5MedDRA: Decreased appetite — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Loss of appetiteMedDRA releases: 2024-11 · check-in free text available
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2022-12-02
Survey response — days 1–6 daily, dose 5MedDRA: Apathy, Brain fog, Memory impairment — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolFree text: Fogginess, apathy, memory changesMedDRA releases: 2024-11 · check-in free text available
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2022-12-03
Survey response — days 1–6 daily, dose 5MedDRA: Apathy, Brain fog, Confusional state, Eye pain — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolFree text: Foggy, apathy, confusion, eye orbital painMedDRA releases: 2024-11 · check-in free text available
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2022-12-04
Survey response — days 1–6 daily, dose 5MedDRA: Asthenopia, Brain fog, Decreased appetite, Depression — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Brain fog, depression, tired eyes, no appetiteMedDRA releases: 2024-11 · check-in free text available
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2022-12-05
Survey response — days 1–6 daily, dose 5MedDRA: Apathy, Brain fog, Pain, Periorbital pain, Photophobia — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend schoolFree text: Peri orbital pain, foggy head, lack of motivation,photophobiaMedDRA releases: 2024-11 · check-in free text available
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2022-12-06
Survey response — days 1–6 daily, dose 5MedDRA: Apathy, Brain fog, Confusional state, Decreased appetite, Eye pain, Photophobia — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend schoolFree text: Eye pain, photophobia, brain fog, apathy, confusion, loss of appetiteMedDRA releases: 2024-11 · check-in free text available
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2022-12-07
Survey response — day 7, dose 5MedDRA: Apathy, Brain fog, Neck pain — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend schoolFree text: Brain fog, neck pain, apathy, lack of motivationMedDRA releases: 2024-11 · check-in free text available
- 2022-12-14
- 2022-12-21
- 2022-12-30
- 2023-01-04
- 2023-01-11
- 2023-03-01
- 2023-06-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Moderna | |
| 2 | 2021-01-19 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
| 5 | 2022-11-30 | Moderna | Flu |
Call center
3 call center cases
2 unsuccessful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Had transient ringing after 5 hours left ear 9/10, lasted for 45 seconds, and dry eyes and blurred vision lasted for 7 hours. Nothing this morning.
Systemic reaction (other): Heavyness of head
Systemic reaction (other): Blurred vision all day.
Release 1 — day 7, dose 1
Systemic reaction (other): Neck pain/ global and temporal region
Release 1 — day 14, dose 1
Symptoms: Severe neck and back pain followed by headache and general malaise. No fever . But chills. No COVID-19 tested.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Hallucinations from high temperatures
Systemic reaction (other): Ear aches, neck pain, Ribs pain when taking a deep breath
Systemic reaction (other): Mental fog, ear aches, some balance issues.
Systemic reaction (other): Costochondritis, difficult in taking deep breath. Left ear ache
Systemic reaction (other): Loss of appetite, glossitis
Systemic reaction (other): Ears and neck, back aches. Itching around the umbilical region
Release 2 — day 7, dose 2
Systemic reaction (other): Ear aches
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Loss of appetite, eye pain, stuffy ears, lack of concentration
Systemic reaction (other): Stuffed left ear, brain fog, General malaise, orbital pain, sensitivity to sound and light, unable to focus and retain
Systemic reaction (other): Left ear less hearing, orbital pain , brain fog, generalized malaise, inability to focus
Systemic reaction (other): Stuffed left year, brain fog, mid back spinal column pain, shoulder pain, nares rash, loss of appetite
Systemic reaction (other): Anger-response to light and sound, brain fog, malaise
Release 10 — day 7, dose 3
Systemic reaction (other): Brain fog, sense of no interest, can't focus. Orbital pain to touch.
Release 10 — day 14, dose 3
Symptoms: Tired, brain fog, eyes burning, not motivated
Release 10 — day 21, dose 3
Symptoms: Brain fogging, depression
Release 10 — day 28, dose 3
Symptoms: Gastric pain, maybe ulcer, and left lower molar gum inflammation started after booster dose slowly from soreness to ulcers. Still have it. Never had ulcers in the past 67 years!
Release 10 — day 35, dose 3
Symptoms: Upper abdominal pain, ulcers, taking antacids for 14 days plan and get upper endoscopy done. Loss of appetite. Lack of motivation.
Release 10 — day 42, dose 3
Symptoms: Tummy aches and on Prilosec OTC. Still hurts
Release 11 — 3 months, dose 3
Symptoms: Gastric ulcers, upper abdominal pain, 15 days treatment with Prilosec. Bloating
Healthcare visit (other): At the hospital consultation with a gastroenterologist
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Periorbital pain, photophobia, brain fog, irritability
Systemic reaction (other): Loss of appetite, peri orbital pain, photophobia
Systemic reaction (other): Brain fog, no appetite, irritability, low concentration
Systemic reaction (other): Brain fog, less concentration. Ear and jaw pain, neck pain, shoulders
Systemic reaction (other): Peri orbital pain, inability to concentrate, brain fog
Release 11 — day 7, dose 4
Systemic reaction (other): Brain fog, joint pain, and periorbital pain, some photophobia
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Loss of appetite
Systemic reaction (other): Fogginess, apathy, memory changes
Systemic reaction (other): Foggy, apathy, confusion, eye orbital pain
Systemic reaction (other): Brain fog, depression, tired eyes, no appetite
Systemic reaction (other): Peri orbital pain, foggy head, lack of motivation,photophobia
Systemic reaction (other): Eye pain, photophobia, brain fog, apathy, confusion, loss of appetite
Release 12 — day 7, dose 5
Systemic reaction (other): Brain fog, neck pain, apathy, lack of motivation
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 |
|---|---|---|---|---|
| HCVO | Emergency care | · | · | ✓ |
| SD | Abdominal distension | · | · | ✓ |
| SD | Abdominal pain | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Apathy | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Depression | · | · | ✓ |
| SD | Eye irritation | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastric ulcer | · | · | ✓ |
| SD | Gastrointestinal ulcer | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Lip blister | · | · | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Noninfective gingivitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Ulcer | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Anger | · | · | ✓ |
| SRO | Apathy | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Asthenopia | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Balance disorder | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Confusional state | · | · | ✓ |
| SRO | Costochondritis | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Depression | · | · | ✓ |
| SRO | Disturbance in attention | · | · | ✓ |
| SRO | Dry eye | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Ear congestion | · | · | ✓ |
| SRO | Ear discomfort | · | · | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Eye pain | · | · | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Glossitis | ✓ | ✓ | ✓ |
| SRO | Hallucination | ✓ | ✓ | ✓ |
| SRO | Head discomfort | ✓ | ✓ | ✓ |
| SRO | Hyperacusis | · | · | ✓ |
| SRO | Hypoacusis | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Memory impairment | · | · | ✓ |
| SRO | Musculoskeletal chest pain | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in jaw | · | · | ✓ |
| SRO | Periorbital pain | · | · | ✓ |
| SRO | Photophobia | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ○ |
| SRO | Rash | · | · | ✓ |
| SRO | Spinal pain | · | · | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release