7UY-29360-27514 · OpenVSafe

Timeline

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

2021-09-11
Dose 1 — Moderna
2021-10-09
Dose 2 — Moderna
2021-10-10
Registered in v-safe
2021-10-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Presyncope — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness and near syncope

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 2
MedDRA: Biliary colic, Chest pain, Chromaturia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Biliary colic, dark urine and chest pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Survey response — days 1–6 daily, dose 2
MedDRA: Biliary colic, Chest pain, Musculoskeletal pain, Pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Biliary colic and chest pain radiating to right shoulder blade posteriorly

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-01-09
Survey response — 3 months, dose 2
MedDRA: Pulmonary embolism — 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, Hospitalization

Free text: Pulmonary emboli x3 and 1 in my abdomen.

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-11
Call 1 — Could Not Reach Participant
2022-01-11
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-11	Moderna	No
2	2021-10-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-09	Successful 2022-01-11	Participant prefers to complete VAERS report online

Free text

Release 10 — days 1–6 daily, dose 2

2021-10-10

Systemic reaction (other): Dizziness and near syncope

2021-10-11

Systemic reaction (other): Biliary colic, dark urine and chest pain

2021-10-12

Systemic reaction (other): Biliary colic and chest pain radiating to right shoulder blade posteriorly

Release 10 — 3 months, dose 2

2022-01-09

Symptoms: Pulmonary emboli x3 and 1 in my abdomen.

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	Pulmonary embolism	·	·	✓
SRO	Biliary colic	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Chromaturia	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Musculoskeletal pain	·	·	✓
SRO	Pain	·	·	✓
SRO	Presyncope	·	·	✓

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