39K-26109-07045 · OpenVSafe

Timeline

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

2021-01-22
Dose 1 — Moderna
2021-02-13
Dose 2 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Chills, Fatigue, Hospitalisation, Immunisation, Pre-existing disease, Pyrexia — Feeling: Good · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Pulmonary doctor advised me not to get second vaccine because of adverse effect of first shot, i.e, hospitalized for 6 days after first shot and am currently on supplemental oxygen. Side effects of started 6 hours after receiving moderna at (b)(6), MA. · Healthcare visit (other): 6 hours after moderna vaccine 1 started to feel tired with chills and fever. It got progressively worst and was hospitalized for 6 days with pneumonia. I am currently on supplemental oxygen. My pulmonary doctor advised me not to get 2nd vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — day 21, dose 1
MedDRA: Chills, Decreased appetite, Dyspnoea, Emergency care, Hospitalisation, Pneumonia, Pyrexia — Feeling: Poor · Get care from a doctor or other healthcare professional · Hospitalization

Free text: 6 hours after vaccine-fever, chills,no appetite, shortness of breath. 2/24 taken by ambulance to hospital for 6 days. No COVID. I had pneumonia. Currently, on supplemental oxygen at home.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-14
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Did not get second moderna because I am on supplemental oxygen and I was in the hospital for 6 days after first moderna vaccine on 1/22/2021. My pulmonary dr advised against 2nd vaccine due to severe after effects from first vaccine shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Call 1 — Could Not Reach Participant
2021-08-04
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-13	Moderna

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 21, dose 1

2021-02-14

Symptoms: 6 hours after vaccine-fever, chills,no appetite, shortness of breath. 2/24 taken by ambulance to hospital for 6 days. No COVID. I had pneumonia. Currently, on supplemental oxygen at home.

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Pulmonary doctor advised me not to get second vaccine because of adverse effect of first shot, i.e, hospitalized for 6 days after first shot and am currently on supplemental oxygen. Side effects of started 6 hours after receiving moderna at (b)(6), MA.

Healthcare visit (other): 6 hours after moderna vaccine 1 started to feel tired with chills and fever. It got progressively worst and was hospitalized for 6 days with pneumonia. I am currently on supplemental oxygen. My pulmonary doctor advised me not to get 2nd vaccine.

redacted (b)(6)

2021-02-17

Systemic reaction (other): Did not get second moderna because I am on supplemental oxygen and I was in the hospital for 6 days after first moderna vaccine on 1/22/2021. My pulmonary dr advised against 2nd vaccine due to severe after effects from first vaccine shot.

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	Chills	✓	✓	✓
HCVO	Fatigue	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Immunisation	✓	✓	✓
HCVO	Pyrexia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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