XX9-10390-72365 · OpenVSafe

Timeline

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

2021-03-11
Dose 1 — Moderna
2021-04-08
Dose 2 — Moderna
2021-04-11
Registered in v-safe
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dysgeusia, Pain in jaw, Toothache — Feeling: Poor · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Hyperhidrosis — Feeling: Fair · Site: Redness · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash macular — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-15
Survey response — 7 day, dose 2
MedDRA: Rash — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-22
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — 28 day, dose 2
MedDRA: Rash, Rash macular — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-15
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-07
Survey response — 6 month, dose 2
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-04-08
Survey response — 12 month, dose 2
MedDRA: Cardiac ablation, Supraventricular tachycardia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11 · check-in answers available
2022-04-08
Report sent to call center — 12 month, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-14
Call 1 — Requested Callback
2022-04-22
Callback requested for
04:30PM ET
2022-04-22
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-04-08	Successful 2022-04-22	Participant prefers to complete VAERS report online

Free text

Release 7

Systemic reaction (other): Jaw, teeth hurt amd metal taste in mouth

Systemic reaction (other): Sweating and shortness of breath but not severe and better than was

Systemic reaction (other): Rash is red blotches

Systemic reaction (other): Rash is dissepating.

Release 8

Symptoms: Had rash and now have little bumps not sure if related or not but did not have before and skin still blotchy. Not itchy though.

Release 10

Symptoms: Since my vaccine I have experienced tingling and numbness in my arm. May be related or may not.

Release 11

Symptoms: SVTs 286 heart rate. Cardiac oblation performed

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
SD	Cardiac ablation	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Supraventricular tachycardia	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Toothache	✓	✓	✓

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