4DB-26638-36328

2 vaccinations 9 coded responses 22 check-ins 9 free-text entries 7 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 323 / FL
Registered: 2020-12-24

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

2020-12-24
Registered in v-safe
2020-12-24
Dose 1 — Moderna
2020-12-24
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2020-12-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-07
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: Mild fatigue. Unsure as to if this is related to the vaccine, however.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-21
Dose 2 — Moderna
2021-01-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Palpitations — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Palpitations · Healthcare visit (other): In house consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-28
Survey response — day 7, dose 2
MedDRA: Palpitations — 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: PALPITATIONS

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Report sent to call center — day 7, dose 2
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)
2021-02-04
Survey response — day 14, dose 2
MedDRA: Medical counselling, Palpitations — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Palpitations and under the care of a cardiologist. Adverse event was filed and it is believed it is from the second vaccine. · Healthcare visit (other): Cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-11
Survey response — day 21, dose 2
MedDRA: Office visit, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Palpitations · Healthcare visit (other): Cardiology

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Survey response — day 28, dose 2
MedDRA: Myocarditis, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Myocarditis · Healthcare visit (other): Cardiology

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Survey response — day 42, dose 2
MedDRA: Cardiac imaging procedure abnormal, Magnetic resonance imaging abnormal, Office visit, Palpitations, Right ventricular enlargement — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Palpitations and right ventricular inflammation s/p MRI · Healthcare visit (other): Specialty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Call 1 — Left Voicemail
2021-06-09
Call 1 — Left Voicemail
2021-07-24
Survey response — 6 months, dose 2
MedDRA: Inflammation, Office visit, Ventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Follow up with cardiology regarding the pvcs and inflammation related to the Moderna vaccine · Healthcare visit (other): Specialist cardiology

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-24
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-29
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-24	Moderna
2	2021-01-21	Moderna

Call center

7 call center cases

7 unsuccessful

VAERS report filed, before or during a call: 6

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 14, dose 1

2021-01-07

Symptoms: Mild fatigue. Unsure as to if this is related to the vaccine, however.

Release 2 — days 1–6 daily, dose 2

2021-01-25

Systemic reaction (other): Palpitations

Healthcare visit (other): In house consultation

2021-01-26

Systemic reaction (other): Palpitations

Release 2 — day 7, dose 2

2021-01-28

Systemic reaction (other): PALPITATIONS

Release 3 — day 14, dose 2

2021-02-04

Symptoms: Palpitations and under the care of a cardiologist. Adverse event was filed and it is believed it is from the second vaccine.

Healthcare visit (other): Cardiologist

Release 4 — day 21, dose 2

2021-02-11

Symptoms: Palpitations

Healthcare visit (other): Cardiology

Release 4 — day 28, dose 2

2021-02-18

Symptoms: Myocarditis

Healthcare visit (other): Cardiology

Release 5 — day 42, dose 2

2021-03-04

Symptoms: Palpitations and right ventricular inflammation s/p MRI

Healthcare visit (other): Specialty

Release 9 — 6 months, dose 2

2021-07-24

Symptoms: Follow up with cardiology regarding the pvcs and inflammation related to the Moderna vaccine

Healthcare visit (other): Specialist cardiology

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Cardiac imaging procedure abnormal	○	✓	○
SD	Fatigue	✓	✓	✓
SD	Inflammation	✓	·	✓
SD	Magnetic resonance imaging abnormal	✓	·	✓
SD	Myocarditis	✓	✓	✓
SD	Office visit	✓	·	✓
SD	Palpitations	✓	✓	✓
SD	Right ventricular enlargement	✓	✓	✓
SD	Unevaluable event	○	○	○
SD	Ventricular extrasystoles	✓	·	✓
SRO	Palpitations	✓	✓	✓

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