22F-10953-84291
4 vaccinations
3 coded responses
52 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 352 / AL
- Registered
- 2021-02-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-20
Dose 1 — Moderna
-
2021-02-21
Registered in v-safe
-
2021-02-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
-
2021-02-27
Health check-in — day 7, dose 1Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-06
- 2021-03-13
- 2021-03-20
-
2021-03-23
Dose 2 — Moderna
- 2021-03-27
- 2021-03-28
-
2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations, Pyrexia — Feeling: GoodFree text: Nothing today, but there is second shot history. Received shot at noon on 3/23. From 5:00am-about 10:00 am had fever. 3/24-27 felt week like recovering from flu. Also on Saturday 3/27 had several hours long heart palpitations. I have these occasionally but never fir more than a couple minutes. Blood pressure was 146/96 with heart rate of 92. By Sunday morning rate was my normal 119/79 heart rate 62.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
-
2021-04-06
Survey response — day 14, dose 2MedDRA: Blood pressure abnormal, Office visit, Palpitations, Pulse abnormal — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Potential arrhythmia. Wearing a heart monitor since yesterday. Symptoms started 4 days post second shot while still recovering from routine shot #2 effects. Initial symptoms were varying blood pressure, pulse and heart palpitations. · Healthcare visit (other): Primary care physician office visit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-06
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-06-22
- 2021-09-21
-
2021-11-01
Dose 3 — Moderna
- 2021-11-01
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Abnormal dreams — Feeling: Poor · Site: 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 activitiesFree text: Psychotic dreamsMedDRA releases: 2024-11 · check-in free text available
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2022-01-31
- 2022-03-18
-
2022-03-18
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-02
-
2022-05-20
Dose 4 — Moderna
- 2022-05-20
-
2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-05-22
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-23
-
2022-05-24
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fever · Chills, Joint pains, Fatigue or tiredness, NauseaAdult check-in
- 2022-05-25
- 2022-05-26
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-08-19
- 2022-11-18
- 2023-05-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-23 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Nothing today, but there is second shot history. Received shot at noon on 3/23. From 5:00am-about 10:00 am had fever. 3/24-27 felt week like recovering from flu. Also on Saturday 3/27 had several hours long heart palpitations. I have these occasionally but never fir more than a couple minutes. Blood pressure was 146/96 with heart rate of 92. By Sunday morning rate was my normal 119/79 heart rate 62.
Release 7 — day 14, dose 2
Symptoms: Potential arrhythmia. Wearing a heart monitor since yesterday. Symptoms started 4 days post second shot while still recovering from routine shot #2 effects. Initial symptoms were varying blood pressure, pulse and heart palpitations.
Healthcare visit (other): Primary care physician office visit.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Psychotic dreams
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 | Blood pressure abnormal | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Pulse abnormal | ✓ | ✓ | ✓ |
| SRO | Abnormal dreams | · | · | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release