YFA-48021-30888 · OpenVSafe

Timeline

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: No rash, but somee itching on my back, but not too intense and sporadic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Itchy back, no rash-Mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Itching periodically on my back-Mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Mild-Itching on back, but less than previous days, no rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Survey response — day 0, dose 2
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Mild soreness on the area around the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Pancreatic carcinoma, Prostate cancer — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diagnosed with stage 2 pancreatic cancer and aggressive prostate cancer.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-11
Survey response — 12 months, dose 2
MedDRA: Pancreatic carcinoma, Prostate cancer — Feeling: Good · Be unable to work or attend school, 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: Diagnosed with Stage 2 Pancreatic Cancer and unrelated aggressive Prostate Cancer at the (b)(6) and (b)(6)

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — 12 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-02-11	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): No rash, but somee itching on my back, but not too intense and sporadic

2021-01-17

Systemic reaction (other): Itchy back, no rash-Mild

2021-01-18

Systemic reaction (other): Itching periodically on my back-Mild

2021-01-19

Systemic reaction (other): Mild-Itching on back, but less than previous days, no rash.

Release 4 — day 0, dose 2

2021-02-11

Systemic reaction (other): Mild soreness on the area around the injection site.

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Diagnosed with stage 2 pancreatic cancer and aggressive prostate cancer.

Release 11 — 12 months, dose 2

2022-02-11

Symptoms: Diagnosed with Stage 2 Pancreatic Cancer and unrelated aggressive Prostate Cancer at the (b)(6) and (b)(6)

redacted (b)(6)

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	Pancreatic carcinoma	✓	·	✓
SD	Prostate cancer	✓	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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