6UK-58682-78716
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 967 / HI
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Registered in v-safe
-
2021-02-09
Dose 1 — Moderna
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
-
2021-02-23
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site swelling — Feeling: GoodFree text: Itching, swelling at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
-
2021-03-09
Dose 2 — Moderna
- 2021-03-09
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-03-12
-
2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Vitreous floaters — Feeling: Fair · Site: ItchingFree text: Since yesterday a gray shape comes and goes while looking with my right eye. Same arm i for the shot in and i know another person who has the same experienceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Vision blurred, Visual impairment — Feeling: Fair · HeadacheFree text: Still blurry vision with a spot in the eye that is the same arm as the shot. One other person that i know of has the same thing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Visual impairment — Feeling: GoodFree text: Still have gray shape in vision in right eye.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — day 7, dose 2MedDRA: Eye disorder — Feeling: FairFree text: Still spot in vision of right eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-15
- 2021-04-20
- 2021-06-08
- 2021-09-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-09 | Moderna |
Free text
Release 4 — day 14, dose 1
Symptoms: Itching, swelling at injection site
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Since yesterday a gray shape comes and goes while looking with my right eye. Same arm i for the shot in and i know another person who has the same experience
Systemic reaction (other): Still blurry vision with a spot in the eye that is the same arm as the shot. One other person that i know of has the same thing.
Systemic reaction (other): Still have gray shape in vision in right eye.
Release 5 — day 7, dose 2
Systemic reaction (other): Still spot in vision of right eye
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 | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Eye disorder | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Vitreous floaters | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release