Y9K-10223-02831 · OpenVSafe

Timeline

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

2021-05-25
Registered in v-safe
2021-05-25
Dose 1 — Moderna
2021-05-25
Survey response — day 0, dose 1
MedDRA: Aphasia, Blindness, Dizziness, Electric shock sensation, Hyperhidrosis, Immediate post-injection reaction, Medical counselling, Paraesthesia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Within a minute of receiving the shot I started to feel dizzy. I went to inform the doctor and by the time I got to the window seconds later my vision was gone. One lady asked me to sit down, but I said I I couldn't see the chair and the doctor came out and took me by the arm and helped me to a chair. Someone brought me water. My dizziness started to clear and vision began to slowly return. I drank a little water and I started sweating all over. My brain felt like an electric charge was being sent through it. I could still talk clearly but it took me about a second or two longer to find a few of the words. I was given some benadryl orally and symptoms continued to gradually disappate over the next few minutes. After everything else mostly felt okay again my arms began tingling from my elbows to my fingertips. · Healthcare visit (other): I was at a Walmart pharmacy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — day 0, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-25	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-25	Unsuccessful

Free text

Release 8 — day 0, dose 1

2021-05-25

Systemic reaction (other): Within a minute of receiving the shot I started to feel dizzy. I went to inform the doctor and by the time I got to the window seconds later my vision was gone. One lady asked me to sit down, but I said I I couldn't see the chair and the doctor came out and took me by the arm and helped me to a chair. Someone brought me water. My dizziness started to clear and vision began to slowly return. I drank a little water and I started sweating all over. My brain felt like an electric charge was being sent through it. I could still talk clearly but it took me about a second or two longer to find a few of the words. I was given some benadryl orally and symptoms continued to gradually disappate over the next few minutes. After everything else mostly felt okay again my arms began tingling from my elbows to my fingertips.

Healthcare visit (other): I was at a Walmart pharmacy

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	Medical counselling	✓	✓	✓
SRO	Aphasia	✓	✓	✓
SRO	Blindness	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Electric shock sensation	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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