32M-27715-00903 · OpenVSafe

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-14
Dose 1 — Moderna
2021-05-12
Dose 2 — Moderna
2021-05-13
Registered in v-safe
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: 1st injection sporadic pain in muscel at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Breast pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Pain in breast

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-06-01
Survey response — day 14, dose 2
MedDRA: Bronchitis, Middle ear effusion, SARS-CoV-2 test negative, Sinusitis, Wheezing — Feeling: Poor · Be unable to work

Free text: Bronchitis, sinusitis full corse medication no result with negitive rapid covid test. 1 week later medication unsuccessful re evaluated chest x ray no pneumonia, secretions ,wheezing , fluid behind ears, another covid test sent out to lab more meds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-11
Survey response — 3 months, dose 2
MedDRA: Dizziness, Emergency care, Flatulence, Headache, Hypertension, Impaired work ability, Office visit — Feeling: Fair · Be unable to work or attend school

Free text: Hypertension on Lisinopril 5 mg found out headache and dizziness visit to ER missed work unexplained dizziness follow up with primary and qas DX with HTN.

MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-12	Moderna

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-13

Systemic reaction (other): 1st injection sporadic pain in muscel at injection site

2021-05-15

Systemic reaction (other): Pain in breast

Release 8 — day 14, dose 2

2021-06-01

Symptoms: Bronchitis, sinusitis full corse medication no result with negitive rapid covid test. 1 week later medication unsuccessful re evaluated chest x ray no pneumonia, secretions ,wheezing , fluid behind ears, another covid test sent out to lab more meds cut off by CDC

Release 9 — 3 months, dose 2

2021-08-11

Symptoms: Hypertension on Lisinopril 5 mg found out headache and dizziness visit to ER missed work unexplained dizziness follow up with primary and qas DX with HTN.

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	Bronchitis	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Emergency care	✓	·	✓
SD	Flatulence	✓	·	✓
SD	Headache	✓	·	✓
SD	Hypertension	✓	·	✓
SD	Impaired work ability	✓	·	✓
SD	Middle ear effusion	✓	✓	✓
SD	Office visit	✓	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Injection site pain	✓	✓	✓

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