OpenVSafe by OpenVAERS
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Z6X-14481-75964

1 vaccination 8 coded responses 15 check-ins 8 free-text entries 4 call cases
Sex
Male
Age at first dose
46-50
ZIP prefix
551 / MN
Registered
2021-04-06
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-06
    Registered in v-safe
  2. 2021-04-06
    Dose 1 — Moderna
  3. 2021-04-06
    Survey response — day 0, dose 1
    MedDRA: Lip swelling — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Joint pains, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: Lip swelling
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Emergency care, Lip swelling — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Muscle or body aches · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Lip swelling i went to regions emergency room they gave me a shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-07
    Report sent to call center — days 1–6 daily, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-04-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-04-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  8. 2021-04-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Adult check-in
  9. 2021-04-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  10. 2021-04-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  11. 2021-04-13
    Health check-in — day 7, dose 1
    Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  12. 2021-04-20
    Survey response — day 14, dose 1
    MedDRA: Chills, Headache, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities
    Free text: HeadachesHot and cold chillsAwful taste buds Feels like im im gonna get sick
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-27
    Survey response — day 21, dose 1
    MedDRA: Genital swelling, Penile swelling — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Swollen penis
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-06
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  15. 2021-05-13
    Survey response — day 35, dose 1
    MedDRA: Abdominal pain upper, Arthralgia, Feeding disorder, Tongue coated — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Sores in headWhite stain on tongueSharp knee painStomach painHave not eat solid food in 7 days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-05-13
    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)
  17. 2021-07-06
    Survey response — 3 months, dose 1
    MedDRA: Decreased appetite, Rash — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Bumps in headLess appetite
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-10-07
    Survey response — 6 months, dose 1
    MedDRA: Abdominal distension, Constipation, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Constipation and bloating for over 2 months. I went to doctors and the medicine given did not work at all. I need help
    MedDRA releases: 2024-11 · check-in free text available
  19. 2021-10-07
    Report sent to call center — 6 months, dose 1
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  20. 2021-10-08
  21. 2022-04-10
    Survey response — 12 months, dose 1
    MedDRA: Adverse reaction, Ageusia, Gait disturbance, Office visit, Pain in extremity, Skin discolouration, Walking aid user — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: I can not walk without a cane. I have to hold rails when i enter any building. When i take baths both feet hurt badly along with both legs. I got no taste bud in my mouth. Everything is bland. My hands are so black now.my hands are so black now. · Healthcare visit (other): Went to primary doctor at (b)(6) Hospital to inform them of reactions.
    MedDRA releases: 2024-11 · check-in free text available
  22. 2022-04-10
    Report sent to call center — 12 months, dose 1
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  23. 2022-04-11

Vaccinations

DoseDateManufacturerCo-administered
12021-04-06Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-04-07 Unsuccessful
2021-05-13 Unsuccessful
2021-10-07 Unsuccessful
2022-04-10 Unsuccessful

Free text

Release 7 — day 0, dose 1

2021-04-06

Systemic reaction (other): Lip swelling

Release 7 — days 1–6 daily, dose 1

2021-04-07

Systemic reaction (other): Lip swelling i went to regions emergency room they gave me a shot

Release 7 — day 14, dose 1

2021-04-20

Symptoms: HeadachesHot and cold chillsAwful taste buds Feels like im im gonna get sick

Release 8 — day 21, dose 1

2021-04-27

Symptoms: Swollen penis

Release 8 — day 35, dose 1

2021-05-13

Symptoms: Sores in headWhite stain on tongueSharp knee painStomach painHave not eat solid food in 7 days

Release 9 — 3 months, dose 1

2021-07-06

Symptoms: Bumps in headLess appetite

Release 10 — 6 months, dose 1

2021-10-07

Symptoms: Constipation and bloating for over 2 months. I went to doctors and the medicine given did not work at all. I need help

Release 11 — 12 months, dose 1

2022-04-10

Symptoms: I can not walk without a cane. I have to hold rails when i enter any building. When i take baths both feet hurt badly along with both legs. I got no taste bud in my mouth. Everything is bland. My hands are so black now.my hands are so black now.
Healthcare visit (other): Went to primary doctor at (b)(6) Hospital to inform them of reactions.
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

FieldPreferred term2021-092023-042024-11
HCVOAdverse reaction · · ✓
HCVOOffice visit · · ✓
SDAbdominal distension · · ✓
SDAbdominal pain upper ✓ ✓ ✓
SDAgeusia · · ✓
SDArthralgia ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDConstipation · · ✓
SDDecreased appetite ✓ ✓ ✓
SDFeeding disorder ✓ ✓ ✓
SDGait disturbance · · ✓
SDGenital swelling ○ ✓ ○
SDHeadache ✓ ✓ ✓
SDNasopharyngitis ✓ ✓ ✓
SDOffice visit · · ✓
SDPain in extremity · · ✓
SDPenile swelling ✓ · ✓
SDRash ✓ ✓ ✓
SDSkin discolouration · · ✓
SDTongue coated ✓ ✓ ✓
SDWalking aid user · · ✓
SROEmergency care ✓ ✓ ✓
SROLip swelling ✓ ✓ ✓

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