22A-20361-32350

4 vaccinations 13 coded responses 33 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 304 / GA
Registered: 2021-04-04

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-02
Dose 1 — Moderna
2021-04-04
Registered in v-safe
2021-04-09
Survey response — day 7, dose 1
MedDRA: Postural orthostatic tachycardia syndrome — Feeling: Poor · Site: Swelling, Itching · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Pre-existing condition: POTS. POTS symptoms worse today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site rash, Pruritus — Feeling: Fair · Be unable to work, 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: Red hot itchy rash appeared at injection site and rapidly spread and worsened. Painful to the touch. POTS symptoms worsened -- HR and BP at medical appointment was 136bpm, 96/88. Doctor prescribed a course of prednisone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 14, dose 1
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)
2021-04-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-30
Dose 2 — Moderna
2021-04-30
Survey response — day 0, dose 2
MedDRA: Heart rate increased, Immediate post-injection reaction — Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: 15 minutes after vaccine administration, heart rate spiked to 180bpm, was monitored while lying on a gurney by paramedics who wanted to send me to the ER, but I declined because it's just a flare of my POTS (Postural Orthostatic Tachycardia Syndrome). I also got VERY hot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Gait inability, Heart rate increased, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: POTS flare -- elevated heart rate, can't walk

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Condition aggravated, Dizziness, Pre-existing disease, Tachycardia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Flare of POTS symptoms -- more frequent and worse tachycardia, chest tightness, light-headedness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Condition aggravated, Dizziness, Injection site rash, Palpitations, Pre-existing disease, Tachycardia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Rash near injection site. Worsening of POTS condition -- increased tachycardia, palpitations, chest tightness, light-headedness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Condition aggravated, Dizziness, Injection site rash, Pre-existing disease, Tachycardia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rash near injection site. Worsening of POTS symptoms -- increased tachycardia, chest tightness, lightheadedness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Worsening of POTS symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-14
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-23
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-04
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-11
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-17
Dose 3 — Moderna
2022-04-01
Call 1 — Left Voicemail
2022-04-30
Survey response — 12 months, dose 2
MedDRA: Brain fog, Condition aggravated, Pre-existing disease — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Drastic worsening of brain fog, increase of ovarian cysts, and increase of ovarian cyst ruptures.

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Report sent to call center — 12 months, dose 2
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 · Emergency room or emergency department visit · 1 call case(s)
2022-05-02
Call 2 — Left Voicemail
2022-10-10
Dose 4 — Moderna
2022-10-10
Survey response — day 0, dose 4
MedDRA: Asthenia, Blindness, Dizziness — Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness, weakness, loss of vision

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Survey response — days 1–6 daily, dose 4
MedDRA: Constipation — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Constipation

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Survey response — days 1–6 daily, dose 4
MedDRA: Constipation — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Constipation

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches

Adult check-in
2022-10-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-17
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2022-10-24
Health check-in — day 14, dose 4
Feeling: Poor

Adult check-in
2022-10-31
Health check-in — day 21, dose 4
Feeling: Poor

Adult check-in
2022-11-07
Health check-in — day 28, dose 4
Feeling: Poor

Adult check-in
2022-11-14
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-22
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-09
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-04-10
Survey response — 6 months, dose 4
MedDRA: Back pain, Gastrointestinal disorder, Jaw disorder — Feeling: Good · 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

MedDRA releases: 2024-11
2023-04-10
Report sent to call center — 6 months, dose 4
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 · 1 call case(s)
2023-04-11
Call 2 — Left Voicemail
2023-04-11
Call 1 — Left Voicemail
2023-04-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-02	Moderna
2	2021-04-30	Moderna
3	2021-12-17	Moderna	No
4	2022-10-10	Moderna	No

Call center

3 call center cases

3 unsuccessful

VAERS report filed, before or during a call: 1

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — day 7, dose 1

2021-04-09

Systemic reaction (other): Pre-existing condition: POTS. POTS symptoms worse today.

Release 7 — day 14, dose 1

2021-04-16

Symptoms: Red hot itchy rash appeared at injection site and rapidly spread and worsened. Painful to the touch. POTS symptoms worsened -- HR and BP at medical appointment was 136bpm, 96/88. Doctor prescribed a course of prednisone.

Release 8 — day 0, dose 2

2021-04-30

Systemic reaction (other): 15 minutes after vaccine administration, heart rate spiked to 180bpm, was monitored while lying on a gurney by paramedics who wanted to send me to the ER, but I declined because it's just a flare of my POTS (Postural Orthostatic Tachycardia Syndrome). I also got VERY hot.

Release 8 — days 1–6 daily, dose 2

2021-05-01

Systemic reaction (other): POTS flare -- elevated heart rate, can't walk

2021-05-02

Systemic reaction (other): Flare of POTS symptoms -- more frequent and worse tachycardia, chest tightness, light-headedness.

2021-05-03

Systemic reaction (other): Rash near injection site. Worsening of POTS condition -- increased tachycardia, palpitations, chest tightness, light-headedness.

2021-05-04

Systemic reaction (other): Rash near injection site. Worsening of POTS symptoms -- increased tachycardia, chest tightness, lightheadedness.

2021-05-06

Systemic reaction (other): Worsening of POTS symptoms

Release 11 — 12 months, dose 2

2022-04-30

Symptoms: Drastic worsening of brain fog, increase of ovarian cysts, and increase of ovarian cyst ruptures.

Release 12 — day 0, dose 4

2022-10-10

Systemic reaction (other): Dizziness, weakness, loss of vision

Release 12 — days 1–6 daily, dose 4

2022-10-11

Systemic reaction (other): Constipation

2022-10-12

Systemic reaction (other): Constipation

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	Back pain	·	·	✓
SD	Brain fog	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Jaw disorder	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SRO	Asthenia	·	·	✓
SRO	Blindness	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Constipation	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Gait inability	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Postural orthostatic tachycardia syndrome	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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