XUL-11975-13861 · OpenVSafe

Timeline

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

2021-06-03
Dose 1 — Moderna
2021-06-10
Registered in v-safe
2021-06-10
Survey response — 7 day, dose 1
MedDRA: Abdominal distension, Dysgeusia, Electric shock sensation, Feeling hot, Feeling jittery, Gastric disorder, Gastrointestinal sounds abnormal, Hypoacusis, Hypoaesthesia, Muscle tightness, Musculoskeletal stiffness, Pallor, Pulseless electrical activity, Tinnitus, Vertigo, Visual impairment — Feeling: Poor · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-18
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-07-01
Health check-in — 28 day, dose 1
Feeling: Fair

Adult check-in
2021-07-08
Health check-in — 35 day, dose 1
Feeling: Good

Adult check-in
2021-07-15
Survey response — 42 day, dose 1
MedDRA: Headache, Liver disorder, Nausea, Unevaluable event — 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

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-07-15
Report sent to call center — 42 day, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-26
Call 1 — Could Not Reach Participant
2021-07-30
Callback requested for
2021-09-02
Survey response — 3 month, dose 1
MedDRA: Aphasia, Cognitive disorder, Depression, Lethargy, Neuropathy peripheral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-12-02
Health check-in — 6 month, dose 1
Feeling: Fair

Adult check-in
2022-06-05
Health check-in — 12 month, dose 1
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-03	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-07-15	Unsuccessful

Free text

Release 9

Systemic reaction (other): Vision changes.. electrical pulses in hands leg & neck..extreme bloating audible stomach activity jittery feeling hands numb tightness in arms & legs vertigo "crickets" in head ears feel warm & muffled hearing & face pale bad taste in mouth

Symptoms: Nausea headache liver comdition

Healthcare visit (other): appt Fri 7/16

Symptoms: unrelated I feel neuropathy however lethargy depression and cognitive impairment with word recall and unable to come up with the word I want to use has been ongoing I am unsure of the origin thinking age-related but it was too sudden of a drop off

Free-text releases are not linked to a specific 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	Unevaluable event	✓	·	✓
SD	Aphasia	✓	·	✓
SD	Cognitive disorder	✓	·	✓
SD	Depression	✓	·	✓
SD	Headache	✓	·	✓
SD	Lethargy	✓	·	✓
SD	Liver disorder	✓	·	✓
SD	Nausea	✓	·	✓
SD	Neuropathy peripheral	✓	·	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Electric shock sensation	✓	·	✓
SRO	Feeling hot	✓	✓	✓
SRO	Feeling jittery	✓	✓	✓
SRO	Gastric disorder	○	✓	○
SRO	Gastrointestinal sounds abnormal	✓	·	✓
SRO	Hypoacusis	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Muscle tightness	○	✓	○
SRO	Musculoskeletal stiffness	✓	·	✓
SRO	Pallor	✓	✓	✓
SRO	Pulseless electrical activity	○	✓	○
SRO	Tinnitus	✓	✓	✓
SRO	Vertigo	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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