Z6Y-33844-10763 · OpenVSafe

Timeline

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

2021-04-07
Dose 1 — Moderna
2021-04-15
Registered in v-safe
2021-04-15
Survey response — day 7, dose 1
MedDRA: Herpes simplex — Feeling: Fair

Free text: A few days after vaccine I had an outbreak of Herpes!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 14, dose 1
MedDRA: Blood magnesium decreased, Blood potassium decreased, Diarrhoea, Fatigue — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Very tired, likely due with ongoing diarrhea as my potassium and magnesium can get low but am aware that since I have LingQT syndrome stay on top of this. Started two days after vaccine but how to know if is the cause?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-05
Dose 2 — Moderna
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Tachycardia — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Tachycardia of -165 bpm for hours at a time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Tachycardia — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Tachycardia for several hours on and off ~150-175 since the day after receiving this shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Tachycardia — Feeling: Fair · Site: Redness · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Tachadardia since day after shot on and off for hours at a time ~175 bpm max sustained. It is exhausting but slowly improving. Dont feel it is emergent so not contacting Dr. since it is just a fast heartrate so assume not dangerous.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-16
Survey response — day 42, dose 2
MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Have a cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Moderna
2	2021-05-05	Moderna

Free text

Release 7 — day 7, dose 1

2021-04-15

Systemic reaction (other): A few days after vaccine I had an outbreak of Herpes!

Release 7 — day 14, dose 1

2021-04-21

Symptoms: Very tired, likely due with ongoing diarrhea as my potassium and magnesium can get low but am aware that since I have LingQT syndrome stay on top of this. Started two days after vaccine but how to know if is the cause?

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Tachycardia of -165 bpm for hours at a time.

2021-05-08

Systemic reaction (other): Tachycardia for several hours on and off ~150-175 since the day after receiving this shot.

2021-05-11

Systemic reaction (other): Tachadardia since day after shot on and off for hours at a time ~175 bpm max sustained. It is exhausting but slowly improving. Dont feel it is emergent so not contacting Dr. since it is just a fast heartrate so assume not dangerous.

Release 9 — day 42, dose 2

2021-06-16

Symptoms: Have a cold

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	Blood magnesium decreased	✓	✓	✓
SD	Blood potassium decreased	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Herpes simplex	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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