3RG-52975-83310

Timeline

1. 2021-03-16
   Registered in v-safe
2. 2021-03-16
   Dose 1 — Moderna
3. 2021-03-16
   Health check-in — day 0, dose 1

   Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

   Adult check-in
4. 2021-03-17
   Health check-in — days 1–6 daily, dose 1

   Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness

   Adult check-in
5. 2021-03-18
   Health check-in — days 1–6 daily, dose 1

   Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

   Adult check-in
6. 2021-03-19
   Survey response — days 1–6 daily, dose 1

   MedDRA: Hypoaesthesia, Lip swelling, Nasopharyngitis, Rhinorrhoea — Feeling: Fair · Site: Redness · Fever · Chills, Fatigue or tiredness · Be unable to work

   Free text: Sniffles and I actually woke up in the middle of the night with a swollen lower lip and numbness in hands. Since I got the shot I feel like I have a cold. And the swollen lower lip scares me a bit but its since gone back to normal.

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
7. 2021-03-20
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · Chills, Diarrhea

   Adult check-in
8. 2021-03-21
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · None

   Adult check-in
9. 2021-03-22
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · None

   Adult check-in
10. 2021-03-25
    Health check-in — day 7, dose 1

    Feeling: Good · None

    Adult check-in
11. 2021-03-30
    Health check-in — day 14, dose 1

    Feeling: Good

    Adult check-in
12. 2021-04-06
    Survey response — day 21, dose 1

    MedDRA: Chills, Disturbance in attention, Fatigue, Office visit, Pyrexia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

    Free text: The fever and chills are still happening on and off. Been feeling unfocused and fatigued the past two weeks. I saw my dr recently about it.

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
13. 2021-04-06
    Report sent to call center — day 21, dose 1

    Get care from a doctor or other healthcare professional

    1 call case(s)
14. 2021-04-16
    Survey response — day 28, dose 1

    MedDRA: Feeling abnormal, Memory impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

    Free text: Feeling foggy, forgetful

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
15. 2021-04-16
    Report sent to call center — day 28, dose 1

    Get care from a doctor or other healthcare professional

    1 call case(s)
16. 2021-04-22
    Health check-in — day 35, dose 1

    Feeling: Good

    Adult check-in
17. 2021-06-15
    Survey response — 3 months, dose 1

    MedDRA: Back pain, Hypoaesthesia, Laboratory test abnormal, Medical counselling, Medical observation, Musculoskeletal stiffness, Pain in extremity, Paraesthesia, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

    Free text: Symptoms: Still numbness and tingling in hands and stiffness and pain in legs and lower back. Blood work after vaccine IS NOW coming back at very high risk for blood clots so Im now on Coumadin for life. I have APLS-autoimmune disease. Drs closely monitori · Healthcare visit (other): Monitored at Anticoagulation clinic twice a week now

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
18. 2021-06-15
    Report sent to call center — 3 months, dose 1

    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

    1 call case(s)
19. 2021-06-17
    Call successful

    Participant prefers to complete VAERS report online
20. 2021-09-15
    Survey response — 6 months, dose 1

    MedDRA: Amnesia, Ophthalmic migraine, Visual impairment, Weight decreased — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

    Free text: Now on warfarin and hydrochloroquin due to blood work showing high risk, recent possible TIA, vision problems, ocular migraine, weigh loss memory loss

    MedDRA releases: 2024-11 · check-in free text available
21. 2021-09-15
    Report sent to call center — 6 months, dose 1

    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

    1 call case(s)
22. 2021-09-16
    Call successful

    Completed over the phone
23. 2022-03-16
    Survey response — 12 months, dose 1

    MedDRA: Amnesia, Depression, Fatigue, Vision blurred — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

    Free text: Extreme fatigue, memory loss., depression, blurry vision

    MedDRA releases: 2024-11 · check-in free text available
24. 2022-03-16
    Report sent to call center — 12 months, dose 1

    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
25. 2022-03-18
    Call 1 — Left Voicemail