47L-21766-05343 · OpenVSafe

Timeline

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

2021-01-25
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-10
Survey response — day 14, dose 1
MedDRA: Back pain, Body temperature, Feeling abnormal, Headache, Injection site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: First week: big headache, mild temperature, sligth pain in the shot area, back pain lung area and around; a few days later brain fog, could not concentrate, or do things I normally do very forgwtfull. Its been 16 days and the brain fog come and goes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Depressed level of consciousness — Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Some Mind cloudiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Muscle or body aches

Free text: Light headed/dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Memory impairment — Feeling: Fair

Free text: Forgetfull

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 21, dose 2
MedDRA: Memory impairment — Feeling: Fair

Free text: I forget things that are simple, comes and goes. It takes me a bit of time to get thing done.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in the lower back of my head.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-30
Dose 3 — Moderna
2022-02-27
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Pain in extremity, Paraesthesia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extrimities tinlging, left hand pain that runs to elbow.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-02-25	Moderna
3	2021-11-30	Moderna	No

Free text

Release 3 — day 14, dose 1

2021-02-10

Symptoms: First week: big headache, mild temperature, sligth pain in the shot area, back pain lung area and around; a few days later brain fog, could not concentrate, or do things I normally do very forgwtfull. Its been 16 days and the brain fog come and goes. cut off by CDC

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Some Mind cloudiness

2021-03-02

Systemic reaction (other): Light headed/dizzy

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): Forgetfull

Release 5 — day 21, dose 2

2021-03-18

Symptoms: I forget things that are simple, comes and goes. It takes me a bit of time to get thing done.

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Pain in the lower back of my head.

Release 11 — 12 months, dose 2

2022-02-27

Symptoms: Extrimities tinlging, left hand pain that runs to elbow.

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	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Body temperature	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Paraesthesia	·	·	✓
SRO	Depressed level of consciousness	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Memory impairment	✓	✓	✓

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