3DT-33977-89651 · OpenVSafe

Timeline

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

2021-03-17
Dose 1 — Moderna
2021-03-18
Registered in v-safe
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiac arrest, Emergency care, Seizure — Feeling: Poor · Be unable to do your normal daily activities

Free text: Seizure and cardiac arrest on 3/22 and now in hospital CCU.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 7, dose 1
MedDRA: Cardiac arrest, Seizure — Feeling: Poor · Be unable to work, 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: Had cardiac arrest and seizure with extensive brain damage on 3 /22/21 and is being removed from respirator to pass.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Survey response — day 14, dose 1
MedDRA: Emergency care, Hospice care, Palliative care, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: See below · Healthcare visit (other): ER, CCU, Palliative, Hospice

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Survey response — day 21, dose 1
MedDRA: Cardiac arrest, Death, Loss of consciousness, Resuscitation, Seizure, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: (b)(6) suffered cardiac arrest and a seizure on 3/22/21 and was revived temporarily but never regained consciousness and died on 4/3/21. · Healthcare visit (other): (b)(6) suffered cardiac arrest and a seizure on 3/22/21 and was revived temporarily but never regained consciousness and died on 4/3/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	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 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Seizure and cardiac arrest on 3/22 and now in hospital CCU.

Release 6 — day 7, dose 1

2021-03-26

Systemic reaction (other): Had cardiac arrest and seizure with extensive brain damage on 3 /22/21 and is being removed from respirator to pass.

Release 6 — day 14, dose 1

2021-03-31

Symptoms: See below

Healthcare visit (other): ER, CCU, Palliative, Hospice

Release 7 — day 21, dose 1

Reports this person's death

2021-04-07

Symptoms: (b)(6) suffered cardiac arrest and a seizure on 3/22/21 and was revived temporarily but never regained consciousness and died on 4/3/21.

Healthcare visit (other): (b)(6) suffered cardiac arrest and a seizure on 3/22/21 and was revived temporarily but never regained consciousness and died on 4/3/21.

redacted (b)(6)

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	Cardiac arrest	✓	·	✓
HCVO	Death	✓	·	✓
HCVO	Emergency care	✓	✓	✓
HCVO	Hospice care	✓	✓	✓
HCVO	Loss of consciousness	✓	·	✓
HCVO	Palliative care	✓	✓	✓
HCVO	Resuscitation	✓	·	✓
HCVO	Seizure	✓	·	✓
HCVO	Unevaluable event	○	✓	○
SD	Cardiac arrest	✓	·	✓
SD	Death	✓	·	✓
SD	Loss of consciousness	✓	·	✓
SD	Resuscitation	✓	·	✓
SD	Seizure	✓	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Cardiac arrest	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Seizure	✓	✓	✓

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