5CH-11177-00867 · OpenVSafe

Timeline

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

2021-07-09
Dose 1 — Moderna
2021-07-10
Registered in v-safe
2021-07-10
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-07-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-07-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache

Adult check-in
2021-07-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-07-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Nausea

Adult check-in
2021-07-16
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Chills, Headache

Adult check-in
2021-07-23
Survey response — day 14, dose 1
MedDRA: Brain fog, Chills, Dizziness, Emergency care, Gait disturbance, Headache, Hypoaesthesia, Paraesthesia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Numbness in my left face, tinting in my legs, massive headache, chills, very foggy felt like when I walked I was not walking straight, felt faint and went to emergency on Sunday 18th

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Survey response — day 35, dose 1
MedDRA: Emergency care, Facial paralysis — Feeling: Fair · Be unable to work or attend school

Free text: I ended up in emergency with facial paralysis, thought I was having a stroke. I had every possible side affect you could have. And will not be getting the second shot.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Survey response — day 42, dose 1
MedDRA: Emergency care, Neurological symptom — Feeling: Fair

Free text: Ended up in emergency with stroke like symptoms. And had every possible side affect you could have and after careful consideration I will not be getting the second dose

MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-09	Moderna	No

Free text

Release 9 — day 14, dose 1

2021-07-23

Symptoms: Numbness in my left face, tinting in my legs, massive headache, chills, very foggy felt like when I walked I was not walking straight, felt faint and went to emergency on Sunday 18th

Release 9 — day 35, dose 1

2021-08-13

Symptoms: I ended up in emergency with facial paralysis, thought I was having a stroke. I had every possible side affect you could have. And will not be getting the second shot.

Release 9 — day 42, dose 1

2021-08-20

Symptoms: Ended up in emergency with stroke like symptoms. And had every possible side affect you could have and after careful consideration I will not be getting the second dose

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	Brain fog	✓	·	✓
SD	Chills	✓	·	✓
SD	Dizziness	✓	·	✓
SD	Emergency care	✓	·	✓
SD	Facial paralysis	✓	·	✓
SD	Gait disturbance	✓	·	✓
SD	Headache	✓	·	✓
SD	Hypoaesthesia	✓	·	✓
SD	Neurological symptom	✓	·	✓
SD	Paraesthesia	✓	·	✓

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