ZJ2-11848-45650 · OpenVSafe

Timeline

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

2021-01-12
Dose 1 — Moderna
2021-01-17
Registered in v-safe
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Loss of personal independence in daily activities, Myalgia, Nausea — Feeling: Good · Site: Pain · Muscle or body aches

Free text: On January 13 I had headache, nausea, muscle aches that prevented me from functioning normally. They improved on the 14th and resolved on the 15th.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2022-01-06
Dose 3 — Pfizer-BioNTech
2022-02-11
Survey response — day 35, dose 3
MedDRA: Atrioventricular block, Atrioventricular block second degree, Cardiac pacemaker insertion, Emergency care, Fatigue, Hepatic enzyme increased, Hospitalisation, Office visit, Pain, Red blood cell sedimentation rate increased — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Vaccine on January 6 followed in 24 hours fatigue aches continued. Diagnosed second degree heart 1/15. Complete heart block 1/18 urgent pacemaker placed, hospitalized. ?Related to vaccine. Sed rate 35. Treponin negative. Elevated liver enzyme call me · Healthcare visit (other): Cardiology twice

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — day 35, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-02-15
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2022-01-06	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-11	Successful 2022-02-15	Participant prefers to complete VAERS report online

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): On January 13 I had headache, nausea, muscle aches that prevented me from functioning normally. They improved on the 14th and resolved on the 15th.

Release 11 — day 35, dose 3

2022-02-11

Symptoms: Vaccine on January 6 followed in 24 hours fatigue aches continued. Diagnosed second degree heart 1/15. Complete heart block 1/18 urgent pacemaker placed, hospitalized. ?Related to vaccine. Sed rate 35. Treponin negative. Elevated liver enzyme call me cut off by CDC

Healthcare visit (other): Cardiology twice

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	Atrioventricular block	·	·	✓
SD	Atrioventricular block second degree	·	·	✓
SD	Cardiac pacemaker insertion	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Hepatic enzyme increased	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Pain	·	·	✓
SD	Red blood cell sedimentation rate increased	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	✓	✓	✓

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