Y8K-13140-13568 · OpenVSafe

Timeline

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

2021-01-28
Dose 1 — Moderna
2021-02-15
Registered in v-safe
2021-02-15
Survey response — day 14, dose 1
MedDRA: Decreased appetite, Influenza like illness, Office visit, Rash, Skin burning sensation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: within 9 hours of the shot, flu like for 3 days, did not feel like eating, 3 day burning skin, rash on back and arm, condition lasted 14 days, doctors said it seemed to be reaction to vaccine · Healthcare visit (other): primary doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Survey response — day 21, dose 1
MedDRA: Malaise, Skin burning sensation, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: After vaccine. Sick for 3 days. Then skin on neck shoulders and arms felt like on fire. Splotches on my face and chest. Took Benadryl. Stayed sick and miserable for 2 weeks. Afraid of next shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call 1 — Left Voicemail
2021-08-02
Call 1 — Left Voicemail
2022-01-30
Health check-in — 12 months, dose 1
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-15	Unsuccessful
2021-02-18	Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-15

Symptoms: within 9 hours of the shot, flu like for 3 days, did not feel like eating, 3 day burning skin, rash on back and arm, condition lasted 14 days, doctors said it seemed to be reaction to vaccine

Healthcare visit (other): primary doctor

Release 4 — day 21, dose 1

2021-02-18

Symptoms: After vaccine. Sick for 3 days. Then skin on neck shoulders and arms felt like on fire. Splotches on my face and chest. Took Benadryl. Stayed sick and miserable for 2 weeks. Afraid of next shot

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
HCVO	Office visit	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Skin burning sensation	✓	✓	✓
SD	Urticaria	✓	✓	✓

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