Z6Y-85024-48362 · OpenVSafe

Timeline

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

2021-02-28
Dose 1 — Moderna
2021-03-28
Dose 2 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Bladder pain — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Severe pain in bladder. I have 300 units of Botox in my bladder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Bladder pain — Feeling: Fair · Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain in bladder (history of Botox shots in bladder)

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

Free text: Pain in bladder. History of Botox in bladder.

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

Free text: Bladder pain. History of Botox injections in bladder

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

Adult check-in
2021-04-20
Survey response — day 21, dose 2
MedDRA: Office visit, Pain, Pre-existing disease — Feeling: Fair · 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: Symptoms: I have an interstim device in my spine connected to nerves of bladder. After shot had severe pain there. After 3 weeks we turned device off and pain subsided. Have never had pain in 5 years until shot · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-04-04
Call 1 — Left Voicemail
2022-04-04
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-28	Moderna
2	2021-03-28	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-20	Successful 2022-04-04	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Severe pain in bladder. I have 300 units of Botox in my bladder

2021-04-02

Systemic reaction (other): Pain in bladder (history of Botox shots in bladder)

2021-04-03

Systemic reaction (other): Pain in bladder. History of Botox in bladder.

Release 6 — day 7, dose 2

2021-04-04

Systemic reaction (other): Bladder pain. History of Botox injections in bladder

Release 7 — day 21, dose 2

2021-04-20

Symptoms: I have an interstim device in my spine connected to nerves of bladder. After shot had severe pain there. After 3 weeks we turned device off and pain subsided. Have never had pain in 5 years until shot

Healthcare visit (other): Doctors 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	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Bladder pain	✓	✓	✓

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