YM3-17694-02211 · OpenVSafe

Timeline

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

2021-03-05
Dose 1 — Moderna
2021-03-29
Registered in v-safe
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good · Chills

Free text: It has only been a few hours Would not expect anything too soon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Pain in extremity — Feeling: Good · Site: Pain · Chills

Free text: Much less pain in arm but still feeling chilly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Dyspnoea — Feeling: Good · Chills

Free text: Chills have lessened but I have a little shortness of breath nothing serious just want to make sure I stay in touch with anything different

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Injection site discolouration — Feeling: Good · Site: Swelling

Free text: My arm is black and blue where I had the shot and I have some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: Doing ok

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 7, dose 2
MedDRA: Dyspnoea — Feeling: Good

Free text: A little short of breath The swelling on my arm has mostly gone down and the black and blue will eventually go away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Fatigue, Office visit, Respiratory disorder — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have had some breathing issues shortness of breath feeling a little fatigued my doctors ordered a breathing test for me I will be doing that on the ninth not that its related to Covid or anything I dont really know whats going on · Healthcare visit (other): Doctor visit in office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-21
Call 1 — Left Voicemail
2021-10-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-02
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-07-02	Unsuccessful

Free text

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): It has only been a few hours Would not expect anything too soon

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Much less pain in arm but still feeling chilly

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Chills have lessened but I have a little shortness of breath nothing serious just want to make sure I stay in touch with anything different

2021-04-07

Systemic reaction (other): My arm is black and blue where I had the shot and I have some shortness of breath

2021-04-08

Systemic reaction (other): Doing ok

Release 7 — day 7, dose 2

2021-04-09

Systemic reaction (other): A little short of breath The swelling on my arm has mostly gone down and the black and blue will eventually go away

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: I have had some breathing issues shortness of breath feeling a little fatigued my doctors ordered a breathing test for me I will be doing that on the ninth not that its related to Covid or anything I dont really know whats going on

Healthcare visit (other): Doctor visit in office

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	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Respiratory disorder	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Injection site discolouration	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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