UZP-13290-82882
2 vaccinations
3 coded responses
3 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 770 / TX
- Registered
- 2021-10-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-09-05
Dose 1 — Moderna
-
2021-10-03
Dose 2 — Moderna
-
2021-10-05
Registered in v-safe
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2021-10-05
Survey response — days 1–6 daily, dose 2MedDRA: Anxiety, Blindness, Blindness transient, Hospitalisation, Pregnancy, Vision blurred — Feeling: Poor · Site: Pain · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Systemic reaction (other): Transient vision loss/blurred vision 5 hours after second dose · Healthcare visit (other): I'm pregnant 26weeks. Loss of vision is concerning so I went to the hospital.MedDRA releases: 2024-11 · check-in free text available
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2021-10-05
Report sent to call center — days 1–6 daily, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
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2021-10-06
Survey response — days 1–6 daily, dose 2MedDRA: Blindness, Vision blurred — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Still trying to figure out why I had blurred/loss of vision 5 hours after vaccine.MedDRA releases: 2024-11 · check-in free text available
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2021-10-06
Report sent to call center — days 1–6 daily, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
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2021-10-07
Survey response — days 1–6 daily, dose 2MedDRA: Blindness, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Vision loss · Healthcare visit (other): Outpatient MRIMedDRA releases: 2024-11 · check-in free text available
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2021-10-07
Report sent to call center — days 1–6 daily, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-10-08
- 2021-10-12
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2021-10-18
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-05 | Moderna | No |
| 2 | 2021-10-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-05 | Successful | Participant prefers to complete VAERS report online |
| 2021-10-06 | Successful | Participant prefers to complete VAERS report online |
| 2021-10-07 | Successful 2021-10-18 |
Participant prefers to complete VAERS report online |
Free text
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Transient vision loss/blurred vision 5 hours after second dose
Healthcare visit (other): I'm pregnant 26weeks. Loss of vision is concerning so I went to the hospital.
Systemic reaction (other): Still trying to figure out why I had blurred/loss of vision 5 hours after vaccine.
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 | Anxiety | · | · | ✓ |
| HCVO | Blindness | · | · | ✓ |
| HCVO | Hospitalisation | · | · | ✓ |
| HCVO | Pregnancy | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SRO | Blindness | · | · | ✓ |
| SRO | Blindness transient | · | · | ✓ |
| SRO | Vision blurred | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release