Z4X-21208-81427 · OpenVSafe

Timeline

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Survey response — day 0, dose 1
MedDRA: Ageusia, Dysgeusia, Hypoaesthesia oral, Paraesthesia — Feeling: Fair

Free text: Strange metallic taste in my mouth, mild numbness in my mouth, loss of taste and tingling sensation. Lasted for about 5 hours. Then all symptoms disappeared except for numbness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Stomatitis — Feeling: Good · Site: Pain

Free text: My mouth still feels odd... like I burnt it on hot coffee.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Survey response — day 28, dose 1
MedDRA: Hospitalisation, Meningitis viral — Feeling: Poor · Be unable to do your normal daily activities

Free text: Hospitalized for symptoms of viral meningitis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 35, dose 1
MedDRA: Hospitalisation, Meningitis viral, Unevaluable event — Feeling: Poor · Be unable to work, 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: Symptoms: Viral meningitis. Was in hospital for 7 days. Have been home for 1 week. No on can tell me if I should get my second shot. I should have received it on Feb 10. . I have asked (b)(6) county, CDC, Moderna and my doctors. PLEASE help me. · Healthcare visit (other): Do you have any data on people who have had a similar type of illness and if they took 2nd shot. Everyone I know who got 2 nd shot got significant flu like symptoms. I dont know if I have what it takes to feel sick again. I am 80 years old.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 35, 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)
2021-02-24
Survey response — day 42, dose 1
MedDRA: Meningitis viral — Feeling: Fair · Be unable to work, 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: I was diagnosed with viral meningitis on 6 Feb 2021. There is no definitive answer as to whether I should get 2nd shot. What do you advise? I am scheduled to get my 2nd shot on 26 Feb.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — day 42, 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)
2021-04-14
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-08-09
Call 1 — Left Voicemail
2022-01-13
Health check-in — 12 months, dose 1
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-17	Unsuccessful
2021-02-24	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-13

Systemic reaction (other): Strange metallic taste in my mouth, mild numbness in my mouth, loss of taste and tingling sensation. Lasted for about 5 hours. Then all symptoms disappeared except for numbness

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): My mouth still feels odd... like I burnt it on hot coffee.

Release 4 — day 28, dose 1

2021-02-10

Symptoms: Hospitalized for symptoms of viral meningitis.

Release 4 — day 35, dose 1

2021-02-17

Symptoms: Viral meningitis. Was in hospital for 7 days. Have been home for 1 week. No on can tell me if I should get my second shot. I should have received it on Feb 10. . I have asked (b)(6) county, CDC, Moderna and my doctors. PLEASE help me.

Healthcare visit (other): Do you have any data on people who have had a similar type of illness and if they took 2nd shot. Everyone I know who got 2 nd shot got significant flu like symptoms. I dont know if I have what it takes to feel sick again. I am 80 years old.

redacted (b)(6)

Release 4 — day 42, dose 1

2021-02-24

Symptoms: I was diagnosed with viral meningitis on 6 Feb 2021. There is no definitive answer as to whether I should get 2nd shot. What do you advise? I am scheduled to get my 2nd shot on 26 Feb.

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	Unevaluable event	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Meningitis viral	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Stomatitis	✓	✓	✓

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