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ZB3-80967-21390

2 vaccinations 2 coded responses 11 check-ins 2 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
079 / NJ
Registered
2021-02-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-19
    Dose 1 — Moderna
  2. 2021-02-16
    Dose 2 — Moderna
  3. 2021-02-20
    Registered in v-safe
  4. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-02-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Aphasia — Feeling: Good · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: On 2/17 approx 18 hours after vaccination #2 and about 2 hours into a hemodialysis treatment I experiemced a trans corny episode of receptive and expressive aphasia. During that time I was attempting to text with my sister who was concerned and texted beck wondering if I was having a stroke. I was unable to read her inquiry at the time. Other staff at the dialysis center noted me acting oddly. The episode spontaeously resolved after about 2.5 hours with no apparent residual effects. There have been no repeated episodes during subsequent treatments.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-02-23
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-03-02
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-03-09
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-03-16
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-03-23
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-03-30
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-05-18
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-08-17
    Survey response — 6 months, dose 2
    MedDRA: Dialysis, Visual impairment — Feeling: Fair
    Free text: Had booster on 8/15. On 8/17 on dialysis had had visual problems that resolved after treatment.
    MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-19Moderna
22021-02-16Moderna

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): On 2/17 approx 18 hours after vaccination #2 and about 2 hours into a hemodialysis treatment I experiemced a trans corny episode of receptive and expressive aphasia. During that time I was attempting to text with my sister who was concerned and texted beck wondering if I was having a stroke. I was unable to read her inquiry at the time. Other staff at the dialysis center noted me acting oddly. The episode spontaeously resolved after about 2.5 hours with no apparent residual effects. There have been no repeated episodes during subsequent treatments.

Release 9 — 6 months, dose 2

2021-08-17

Symptoms: Had booster on 8/15. On 8/17 on dialysis had had visual problems that resolved after treatment.

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
SDDialysis ✓ · ✓
SDVisual impairment ✓ · ✓
SROAphasia ✓ ✓ ✓

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