3Q5-41227-43800
2 vaccinations
9 coded responses
10 check-ins
9 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 604 / IL
- Registered
- 2021-04-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-16
Dose 1 — Moderna
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2021-04-12
Dose 2 — Moderna
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2021-04-15
Registered in v-safe
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations — Feeling: Fair · FeverFree text: Heart palpitations since my first shot on and offMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations — Feeling: Good · Site: SwellingFree text: Heart PalpitationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — day 7, dose 2MedDRA: Palpitations — Feeling: Good · Site: PainFree text: Heart PalpitationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-26
Survey response — day 14, dose 2MedDRA: Chest pain, Hospitalisation, Palpitations — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Was hospitalized for sever chest pains like a heart attack and palpitations.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-26
Report sent to call center — day 14, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-03
Survey response — day 21, dose 2MedDRA: Hospitalisation, Palpitations — 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, HospitalizationFree text: Heart Palpitations, severe enough to have to go to the emergency, I was admitted for observation, given a 24 hour heart monitorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-03
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-10
Survey response — day 28, dose 2MedDRA: Dysgeusia, Gingival bleeding — Feeling: GoodFree text: Bleeding gums every day, metal taste in my mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-17
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2021-05-24
Survey response — day 42, dose 2MedDRA: Palpitations — Feeling: Good · 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: Heart Palpitations still happeningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-24
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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2021-07-13
Survey response — 3 months, dose 2MedDRA: Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Heart palpitations still happening.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-13
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-22
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2021-10-11
Survey response — 6 months, dose 2MedDRA: Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I am still having the heart palpitations dailyMedDRA releases: 2024-11 · check-in free text available
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2021-10-11
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2021-10-12
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-12 | Moderna |
Call center
5 call center cases
1 successful · 4 unsuccessful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Heart palpitations since my first shot on and off
Systemic reaction (other): Heart Palpitations
Release 7 — day 7, dose 2
Systemic reaction (other): Heart Palpitations
Release 8 — day 14, dose 2
Symptoms: Was hospitalized for sever chest pains like a heart attack and palpitations.
Release 8 — day 21, dose 2
Symptoms: Heart Palpitations, severe enough to have to go to the emergency, I was admitted for observation, given a 24 hour heart monitor
Release 8 — day 28, dose 2
Symptoms: Bleeding gums every day, metal taste in my mouth
Release 8 — day 42, dose 2
Symptoms: Heart Palpitations still happening
Release 9 — 3 months, dose 2
Symptoms: Heart palpitations still happening.
Release 10 — 6 months, dose 2
Symptoms: I am still having the heart palpitations daily
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 | Chest pain | ✓ | ✓ | ✓ |
| SD | Dysgeusia | ✓ | ✓ | ✓ |
| SD | Gingival bleeding | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release