Y6C-11303-02101 · OpenVSafe

Timeline

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

2021-04-14
Dose 1 — Moderna
2021-04-16
Registered in v-safe
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-12
Dose 2 — Moderna
2021-05-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-05-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-16
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Been having headaches probably weather

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-11
Survey response — 3 months, dose 2
MedDRA: Urinary tract infection — Feeling: Good

Free text: UTI

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-10
Survey response — 6 months, dose 2
MedDRA: Blood urine present, Nephrolithiasis — Feeling: Good

Free text: Having surgery December 1st for possible tumor in tube from bladder to left kidney and removal of to very large stones in right kidney (blood in urine since September 1st)

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — 12 months, dose 2
MedDRA: COVID-19 pneumonia, Emergency care, Hospitalisation, Oxygen therapy, Renal stone removal, Sepsis — Feeling: Good · 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: Sepsis ER and four week hospital stay,December 26th- January 19th.COVID, I am now on 2L Oxygen 24/7,because of having COVID Pneumonia.Large Kidney Stones(with two surgeries to remove them)

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-12	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-05-12	Unsuccessful

Free text

Release 9 — day 35, dose 2

2021-06-16

Symptoms: Been having headaches probably weather

Release 9 — 3 months, dose 2

2021-08-11

Symptoms: UTI

Release 10 — 6 months, dose 2

2021-11-10

Symptoms: Having surgery December 1st for possible tumor in tube from bladder to left kidney and removal of to very large stones in right kidney (blood in urine since September 1st)

Release 11 — 12 months, dose 2

2022-05-12

Symptoms: Sepsis ER and four week hospital stay,December 26th- January 19th.COVID, I am now on 2L Oxygen 24/7,because of having COVID Pneumonia.Large Kidney Stones(with two surgeries to remove them)

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	Blood urine present	·	·	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Emergency care	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Oxygen therapy	·	·	✓
SD	Renal stone removal	·	·	✓
SD	Sepsis	·	·	✓
SD	Urinary tract infection	✓	·	✓

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