2MT-12615-35590
4 vaccinations
6 coded responses
32 check-ins
6 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 917 / CA
- Registered
- 2021-01-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-31
Registered in v-safe
-
2021-01-31
Dose 1 — Moderna
- 2021-01-31
-
2021-02-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-07
- 2021-02-14
- 2021-02-21
-
2021-02-28
Dose 2 — Moderna
- 2021-02-28
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-03-02
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Chills, Fatigue or tirednessAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-09
- 2021-03-14
- 2021-03-21
-
2021-03-30
Survey response — day 28, dose 2MedDRA: Palpitations — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Racing heartMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Survey response — day 35, dose 2MedDRA: Atrial fibrillation, Heart rate increased — Feeling: Poor · Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: High heart rate. A-feb In ER now. · Healthcare visit (other): In ER right now. A-fib - high heart rate. Not sure if there is any correlation with vaccine or not. Given drugs; feeling better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-11
Survey response — day 42, dose 2MedDRA: Atrial fibrillation, Hospitalisation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Hospitalization for AFib · Healthcare visit (other): AFibMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-30
Survey response — 3 months, dose 2MedDRA: Atrial fibrillation, Atrial flutter, Emergency care, Heart rate increased, Heart rate irregular, Hospitalisation — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Was hospitalized and diagnosed for new onset A-Fib and A-Flutter. I received by 2nd COVID shot on 2/28/21 and the symptoms of this irregular and fast heart rate started on 3/14/2021. Reported this at last check-in and NO one has followed up with me! · Healthcare visit (other): Numerous tests & procedures both in hospital and out. Scheduled for cardiac ablation!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-30
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-15
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2021-08-29
Survey response — 6 months, dose 2MedDRA: Atrial fibrillation, Atrial flutter, Cardiac ablation — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Just had cardio ablation done on Friday for AFib and AFib Flutter which onset about 2- weeks after 2nd shot. · Healthcare visit (other): Cardio Ablation doneMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-29
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-02
-
2021-11-26
Dose 3 — Moderna
- 2022-03-02
-
2022-04-12
Dose 4 — Moderna
- 2022-04-25
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
-
2022-07-12
Survey response — 3 months, dose 4MedDRA: Cardiac ablation, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, HospitalizationFree text: Symptoms: Sinus infection. Also, had a 2nd cardiac ablation on 7.1.2022 · Healthcare visit (other): Cardiac ablationMedDRA releases: 2024-11 · check-in free text available
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2022-07-12
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
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2022-07-13
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-31 | Moderna | |
| 2 | 2021-02-28 | Moderna | |
| 3 | 2021-11-26 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Call center
5 call center cases
5 successful
Free text
Release 6 — day 28, dose 2
Symptoms: Racing heart
Release 6 — day 35, dose 2
Symptoms: High heart rate. A-feb In ER now.
Healthcare visit (other): In ER right now. A-fib - high heart rate. Not sure if there is any correlation with vaccine or not. Given drugs; feeling better.
Release 7 — day 42, dose 2
Release 8 — 3 months, dose 2
Symptoms: Was hospitalized and diagnosed for new onset A-Fib and A-Flutter. I received by 2nd COVID shot on 2/28/21 and the symptoms of this irregular and fast heart rate started on 3/14/2021. Reported this at last check-in and NO one has followed up with me! cut off by CDC
Healthcare visit (other): Numerous tests & procedures both in hospital and out. Scheduled for cardiac ablation!
Release 9 — 6 months, dose 2
Symptoms: Just had cardio ablation done on Friday for AFib and AFib Flutter which onset about 2- weeks after 2nd shot.
Healthcare visit (other): Cardio Ablation done
Release 12 — 3 months, dose 4
Symptoms: Sinus infection. Also, had a 2nd cardiac ablation on 7.1.2022
Healthcare visit (other): Cardiac ablation
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 | Atrial fibrillation | ✓ | ✓ | ✓ |
| HCVO | Cardiac ablation | ✓ | · | ✓ |
| HCVO | Emergency care | ✓ | ✓ | ✓ |
| HCVO | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Atrial fibrillation | ✓ | ✓ | ✓ |
| SD | Atrial flutter | ✓ | ✓ | ✓ |
| SD | Cardiac ablation | ✓ | · | ✓ |
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Heart rate irregular | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Sinusitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release