5QW-99572-59175 · OpenVSafe

Timeline

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

2021-01-06
Dose 1 — Moderna
2021-02-03
Dose 2 — Moderna
2021-02-15
Registered in v-safe
2021-02-15
Survey response — day 7, dose 2
MedDRA: Hospitalisation, Influenza like illness, Pericarditis — Feeling: Fair · Site: Pain · Chills, Joint pains, Fatigue or tiredness · 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 flu like symptoms that day and 2 days after. Developed pericarditis that Friday night, went to ER Saturday morning, and was in the hospital for 3 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — day 7, dose 2
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)
2021-02-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-15	Unsuccessful

Free text

Release 4 — day 7, dose 2

2021-02-15

Systemic reaction (other): Had flu like symptoms that day and 2 days after. Developed pericarditis that Friday night, went to ER Saturday morning, and was in the hospital for 3 days

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
SRO	Hospitalisation	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Pericarditis	✓	✓	✓

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