Z9F-33033-11199 · OpenVSafe

Timeline

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

2021-03-04
Dose 1 — Moderna
2021-03-08
Registered in v-safe
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Day if shot odd taste in mouth all day. Like cardboard or whwn you drink from a waxy paper cup

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Glassy eyes, Lacrimation increased, Ocular discomfort — Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eye pressure in my left eye, eyes glossy and runny

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Eye pain, Ocular discomfort, Ocular hypertension, Ophthalmological examination, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My occular hypertension went up 3 points. Had eye exam today due to feeling pressure and slight pain in L eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — day 7, dose 1
MedDRA: Eye pain, Pre-existing disease — Feeling: Good · Headache

Free text: Still have slight eye pain..level 1-2. Did get prescription eye drops for occular hyoer tension that went up 3points yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Eye pain, Ocular hypertension, Pre-existing disease, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have a rash my arms and legs that is persistent. I also have slightnpain in my left eye that has not neen alleviated by medicinal eye drops. My occular hypertension rose 3mm after the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-12-09
Call 1 — Requested Callback
2021-12-10
Callback requested for
11:30AM ET
2021-12-10
Callback requested for
11:30AM ET
2021-12-14
Call 2 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-10	Unsuccessful
2021-03-18	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-08

Systemic reaction (other): Day if shot odd taste in mouth all day. Like cardboard or whwn you drink from a waxy paper cup

2021-03-09

Systemic reaction (other): Eye pressure in my left eye, eyes glossy and runny

2021-03-10

Systemic reaction (other): My occular hypertension went up 3 points. Had eye exam today due to feeling pressure and slight pain in L eye

Release 5 — day 7, dose 1

2021-03-11

Systemic reaction (other): Still have slight eye pain..level 1-2. Did get prescription eye drops for occular hyoer tension that went up 3points yesterday.

Release 5 — day 14, dose 1

2021-03-18

Symptoms: I have a rash my arms and legs that is persistent. I also have slightnpain in my left eye that has not neen alleviated by medicinal eye drops. My occular hypertension rose 3mm after the vaccine.

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	Condition aggravated	✓	·	✓
SD	Eye pain	✓	✓	✓
SD	Ocular hypertension	○	✓	○
SD	Pre-existing disease	✓	·	✓
SD	Rash	✓	✓	✓
SRO	Condition aggravated	✓	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Glassy eyes	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Ocular hypertension	○	✓	○
SRO	Ophthalmological examination	○	✓	○
SRO	Pre-existing disease	✓	✓	✓

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