3SL-51486-59879 · OpenVSafe

Timeline

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

2021-02-25
Dose 1 — Moderna
2021-03-25
Dose 2 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Survey response — day 7, dose 2
MedDRA: Balance disorder, Memory impairment — Feeling: Good · Fatigue or tiredness

Free text: Balance off, appears suddenly. Short term memory sporadically deficient, like never experienced before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Arthropod bite, Blister, Chest pain, Discomfort, Herpes zoster, Office visit, Pain, Pruritus, Rash — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Unknown tick bite - no immediate systemic response other than bite area-dismissed by PAShingles- 3 days of atypical pain & discomfort on lt thorax, frt & bj. 3rd day, painful, itchy several blistered, but # slight rash line below lt breast · Healthcare visit (other): Office visit for each episode

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-27
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis, Sinusitis — Feeling: Fair

Free text: Head cold/ sinusitis symptoms

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): Balance off, appears suddenly. Short term memory sporadically deficient, like never experienced before.

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Unknown tick bite - no immediate systemic response other than bite area-dismissed by PAShingles- 3 days of atypical pain & discomfort on lt thorax, frt & bj. 3rd day, painful, itchy several blistered, but # slight rash line below lt breast

Healthcare visit (other): Office visit for each episode

Release 11 — 12 months, dose 2

2022-03-27

Symptoms: Head cold/ sinusitis symptoms

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	Office visit	·	·	✓
SD	Arthropod bite	·	·	✓
SD	Blister	·	·	✓
SD	Chest pain	·	·	✓
SD	Discomfort	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	·	·	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Balance disorder	✓	✓	✓
SRO	Memory impairment	✓	✓	✓

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