Z92-13709-16709 · OpenVSafe

Timeline

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

2021-05-28
Registered in v-safe
2021-05-28
Dose 1 — Moderna
2021-05-28
Survey response — day 0, dose 1
MedDRA: Pain — Feeling: Good

Free text: Normal level of pain etc

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches

Adult check-in
2021-05-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-05-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-06-04
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Joint pains

Free text: Mouth, eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 14, dose 1
MedDRA: Chest discomfort, Erythema, Muscle spasms, Pre-existing disease, Pyrexia, Stomatitis — Feeling: Fair

Free text: Leg cramps, night fever, chest heat feeling, mouth inflamation, red face..off and on..i have autoimmune situation normally sensitive.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Survey response — day 21, dose 1
MedDRA: Chills, Fatigue, Pain, Self-medication, Sneezing — Feeling: Fair · Be unable to work or attend school

Free text: Sneezing, chills, body pain went back to bed took tylenol, felt better,tired,got out of bed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Survey response — day 28, dose 1
MedDRA: Asthenia, Eye pain, Headache, Oral pain, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pain....head pain, generally just weak..trying CBD honey for pain..still some taste,smell,eyes, mouth soreness wait till it gets better, might have covid ..stay close to home sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Survey response — day 35, dose 1
MedDRA: Asthenia, Brain fog, Ear pain, Loss of personal independence in daily activities, Pain, Pain in jaw, Toothache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Body pain more severe, weakness, teeth jaw, ears painful..could not shop,used a motorized cart,had to just go home,mental fog.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Survey response — day 42, dose 1
MedDRA: Asthenia, Chest pain, Neck pain, Pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities

Free text: Pain,chest pain,over all body feeling weak,eyes funny,head neck more pain,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-28	Moderna

Free text

Release 8 — day 0, dose 1

2021-05-28

Systemic reaction (other): Normal level of pain etc

Release 8 — day 7, dose 1

2021-06-04

Systemic reaction (other): Mouth, eyes

Release 9 — day 14, dose 1

2021-06-11

Symptoms: Leg cramps, night fever, chest heat feeling, mouth inflamation, red face..off and on..i have autoimmune situation normally sensitive.

Release 9 — day 21, dose 1

2021-06-18

Symptoms: Sneezing, chills, body pain went back to bed took tylenol, felt better,tired,got out of bed.

Release 9 — day 28, dose 1

2021-06-27

Symptoms: Pain....head pain, generally just weak..trying CBD honey for pain..still some taste,smell,eyes, mouth soreness wait till it gets better, might have covid ..stay close to home sneezing

Release 9 — day 35, dose 1

2021-07-02

Symptoms: Body pain more severe, weakness, teeth jaw, ears painful..could not shop,used a motorized cart,had to just go home,mental fog.

Release 9 — day 42, dose 1

2021-07-09

Symptoms: Pain,chest pain,over all body feeling weak,eyes funny,head neck more pain,

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	Asthenia	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Oral pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Stomatitis	✓	✓	✓
SD	Toothache	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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