ZXX-14078-76383 · OpenVSafe

Timeline

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

2021-03-25
Dose 1 — Moderna
2021-04-23
Dose 2 — Moderna
2021-05-03
Registered in v-safe
2021-05-03
Survey response — day 7, dose 2
MedDRA: Pain in extremity, Peripheral embolism, Pulmonary embolism, Thrombosis, Unevaluable event — Feeling: Poor · Site: Pain · Joint pains, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Pain in left calf · Healthcare visit (other): Blood Clots, PE left lung and both legs. Left leg worst than right leg.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Survey response — day 14, dose 2
MedDRA: Emergency care, Thrombosis — Feeling: Poor · Be unable to work

Free text: Blood clotting in both legs, left leg worst than right, and PEs on both lungs. Admission to ER and ICU for treatments!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 21, dose 2
MedDRA: Antiphospholipid syndrome — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: I was diagnosed with ASP. Antiphospholipid syndrome.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-23
Survey response — day 28, dose 2
MedDRA: Thrombosis, Urinary bladder haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Blood clotting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-30
Survey response — day 35, dose 2
MedDRA: Hospitalisation — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Developed blood clots and bi-lateral PEs, needing to be hospitalized in ICU. In patient for 3 weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-06
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-23
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Pain in extremity, Pre-existing disease — Feeling: Fair · Be unable to work or attend school

Free text: Pain in legs / hip areas where my blood clots were.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-29
Call 1 — Left Voicemail
2022-04-26
Survey response — 12 months, dose 2
MedDRA: Blood disorder, Thrombosis — Feeling: Fair · Be unable to work or attend school

Free text: Clotting in leg, blood disorder

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-23	Moderna

Call center

4 call center cases

4 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 8 — day 7, dose 2

2021-05-03

Systemic reaction (other): Pain in left calf

Healthcare visit (other): Blood Clots, PE left lung and both legs. Left leg worst than right leg.

Release 8 — day 14, dose 2

2021-05-07

Symptoms: Blood clotting in both legs, left leg worst than right, and PEs on both lungs. Admission to ER and ICU for treatments!

Release 8 — day 21, dose 2

2021-05-15

Symptoms: I was diagnosed with ASP. Antiphospholipid syndrome.

Release 8 — day 28, dose 2

2021-05-23

Symptoms: Blood clotting

Release 8 — day 35, dose 2

2021-05-30

Symptoms: Developed blood clots and bi-lateral PEs, needing to be hospitalized in ICU. In patient for 3 weeks.

Release 9 — 3 months, dose 2

2021-07-23

Symptoms: Pain in legs / hip areas where my blood clots were.

Release 11 — 12 months, dose 2

2022-04-26

Symptoms: Clotting in leg, blood disorder

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	Peripheral embolism	○	✓	○
HCVO	Pulmonary embolism	✓	✓	✓
HCVO	Thrombosis	✓	✓	✓
HCVO	Unevaluable event	✓	·	✓
SD	Antiphospholipid syndrome	✓	✓	✓
SD	Arthralgia	✓	·	✓
SD	Blood disorder	·	·	✓
SD	Emergency care	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Pain in extremity	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Thrombosis	✓	✓	✓
SD	Urinary bladder haemorrhage	○	✓	○
SRO	Pain in extremity	✓	✓	✓

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