2LX-81477-39724
1 vaccination
7 coded responses
11 check-ins
7 free-text entries
6 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 462 / IN
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Registered in v-safe
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2021-01-04
Dose 1 — Moderna
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2021-01-04
Survey response — day 0, dose 1MedDRA: Cough, Respiratory tract irritation — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Cough, like a tickle in my chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-04
Report sent to call center — day 0, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
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2021-01-06
Survey response — days 1–6 daily, dose 1MedDRA: SARS-CoV-2 test — Feeling: Good · Fatigue or tirednessFree text: I received the results of a PCR COVID-19 spit test today. The results were “detected.â€MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-07
Survey response — days 1–6 daily, dose 1MedDRA: COVID-19 — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: I was diagnosed with COVID yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-07
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2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: COVID-19 — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to workFree text: Diagnosed with COVID-19 on 01/05/21MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-08
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2021-01-09
Survey response — days 1–6 daily, dose 1MedDRA: COVID-19 — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to workFree text: COVID diagnosis 01/05, Bamlanivimab infusion todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-09
- 2021-01-18
- 2021-01-25
- 2021-02-01
- 2021-02-08
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2021-07-05
Survey response — 6 months, dose 1MedDRA: Atrial flutter, Cardiac ablation, Cardioversion, Dyspnoea exertional — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Atrial flutter dxd 8 weeks post-COVID diagnosis. Unsuccessful cardioversion. Cardiac ablation, which was successful. However, I have ongoing shortness of breath with mild exertion. Currently wearing a 30-day heart monitor & schdd for ECHO · Healthcare visit (other): Cardiac ablationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-05
Report sent to call center — 6 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-07
Call successfulParticipant prefers to complete VAERS report online
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2022-01-04
Survey response — 12 months, dose 1MedDRA: Atrial flutter, Bradycardia, Cardiac ablation, Cardiac pacemaker insertion, Office visit, Surgery — 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 · HospitalizationFree text: Symptoms: I was diagnosed with atrial flutter on 03/10/20 & had a cardiac ablation on 05/20/2021. My cardiologist then determined I had bradycardia on 07/07/2021 (HR ~29) & placed a pacemaker on 07/22/2021. The pacemaker is pacing me ~60% of the time. · Healthcare visit (other): Out-patient surgery (pacemaker)MedDRA releases: 2024-11 · check-in free text available
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2022-01-04
Report sent to call center — 12 months, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
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2022-01-05
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna |
Call center
6 call center cases
2 successful · 4 priority 2/3 (triaged and no follow up)
VAERS report filed, before or during a call: 1
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Cough, like a tickle in my chest
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): I received the results of a PCR COVID-19 spit test today. The results were “detected.â€
Systemic reaction (other): I was diagnosed with COVID yesterday
Systemic reaction (other): Diagnosed with COVID-19 on 01/05/21
Systemic reaction (other): COVID diagnosis 01/05, Bamlanivimab infusion today
Release 9 — 6 months, dose 1
Symptoms: Atrial flutter dxd 8 weeks post-COVID diagnosis. Unsuccessful cardioversion. Cardiac ablation, which was successful. However, I have ongoing shortness of breath with mild exertion. Currently wearing a 30-day heart monitor & schdd for ECHO
Healthcare visit (other): Cardiac ablation
Release 10 — 12 months, dose 1
Symptoms: I was diagnosed with atrial flutter on 03/10/20 & had a cardiac ablation on 05/20/2021. My cardiologist then determined I had bradycardia on 07/07/2021 (HR ~29) & placed a pacemaker on 07/22/2021. The pacemaker is pacing me ~60% of the time.
Healthcare visit (other): Out-patient surgery (pacemaker)
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 | Cardiac ablation | ✓ | ✓ | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Atrial flutter | ✓ | ✓ | ✓ |
| SD | Bradycardia | · | · | ✓ |
| SD | Cardiac ablation | · | · | ✓ |
| SD | Cardiac pacemaker insertion | · | · | ✓ |
| SD | Cardioversion | ✓ | ✓ | ✓ |
| SD | Dyspnoea exertional | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | COVID-19 | ✓ | ✓ | ✓ |
| SRO | Infusion | ○ | ○ | ○ |
| SRO | Respiratory tract irritation | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test negative | ○ | ○ | ○ |
| SRO | SARS-CoV-2 test positive | ○ | ○ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release