4GA-74706-18523

2 vaccinations 17 coded responses 27 check-ins 17 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 321 / FL
Registered: 2021-06-02

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

2021-06-02
Registered in v-safe
2021-06-02
Dose 1 — Moderna
2021-06-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-06-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-06-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-06-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-07
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate decreased — Feeling: Fair

Free text: Lower resting heart rate than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — days 1–6 daily, dose 1
MedDRA: Bradycardia, Dizziness, Head discomfort — Feeling: Poor · Be unable to work

Free text: Bradycardia, Dizziness, and head pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Survey response — day 7, dose 1
MedDRA: Dizziness, Menstrual disorder — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Dizziness, Menstrual Period started 2 days ago and has been very abnormally light

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Survey response — day 14, dose 1
MedDRA: Dizziness, Fatigue, Nausea, Postural orthostatic tachycardia syndrome, Sleep disorder, Supraventricular tachycardia, Unevaluable event, Weight decreased — Feeling: Poor · Be unable to work or attend school, 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: Symptoms: I have developed POTS (postural tachycardia), had a SVT episode last night, & Im lightheaded and intensely dizzy every day. I get bouts of nausea, Ive lost 6 pounds in a week, and I am exhausted every day. My sleep is significantly disturbed. · Healthcare visit (other): Seeing my primary next week and hopefully neurology after that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — day 14, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-23
Survey response — day 21, dose 1
MedDRA: Blood pressure increased, Blood thyroid stimulating hormone decreased, Body temperature increased, Fatigue, Hypertension, Postural orthostatic tachycardia syndrome, Thyroid hormones decreased — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Low TSH level, raised blood pressure, postural tachycardia (POTS), 99.1 temperature (Im always 97.4-97.6) and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Call successful
Participant prefers to complete VAERS report online
2021-07-02
Survey response — day 28, dose 1
MedDRA: Back pain, Condition aggravated, Extrasystoles, Neck pain, Pain in extremity, Pre-existing disease — Feeling: Poor · Be unable to work or attend school

Free text: I continue to suffer from symptoms of postural Orthostatic tachycardia syndrome (POTS) but developed excessive ectopic heartbeats, and intense left neck, left upper arm, and left upper back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-07-14
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-07-31
Dose 2 — Moderna
2021-07-31
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-01
Survey response — days 1–6 daily, dose 2
MedDRA: Blepharospasm, Chest pain, Postural orthostatic tachycardia syndrome, Tachycardia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Free text: Chest pain off and on, right eyelid twitching off and on, tachycardia, POTS

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-08-03
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Chest discomfort, Chest pain, Dyspepsia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Chest pains, chest tightness, indigestion, anxiety attack

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Dizziness on and off

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Survey response — days 1–6 daily, dose 2
MedDRA: Postural orthostatic tachycardia syndrome, Tachycardia — Feeling: Fair · Headache, Fatigue or tiredness

Free text: POTS symptoms (tachycardia upon standing/walking)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Survey response — days 1–6 daily, dose 2
MedDRA: Extrasystoles, Postural orthostatic tachycardia syndrome — Feeling: Good

Free text: POTS (tachycardia on standing), and ectopic heartbeats when exerting myself

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Survey response — day 7, dose 2
MedDRA: Bradycardia, Postural orthostatic tachycardia syndrome — Feeling: Good

Free text: POTS (postural tachycardia) and bradycardia when sleeping

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-14
Survey response — day 14, dose 2
MedDRA: Muscle tightness, Pulse abnormal — Feeling: Fair

Free text: Pulsation in neck that is visible and neck tightness. This has been going on for almost 2 weeks.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Survey response — day 21, dose 2
MedDRA: Neck pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Neck pain around my carotid artery area that started after I got the second vaccine. I have a doctors appt in 2 days to get it checked out.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Call successful
Participant prefers to complete VAERS report online
2021-08-28
Survey response — day 28, dose 2
MedDRA: Pulse abnormal, Vasodilatation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Veins in neck pulsate. Doctor concerned about vein distention that did not exist prior to the shot.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-28
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call successful
Participant prefers to complete VAERS report online
2021-09-04
Survey response — day 35, dose 2
MedDRA: Postural orthostatic tachycardia syndrome, Supraventricular extrasystoles, Thyroid disorder, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Thyroid issues, POTS (postural Orthostatic tachycardia syndrome), and PVCs/PACs on exertion.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-04
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-09
Call 1 — Left Voicemail
2021-09-11
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-11-01
Survey response — 3 months, dose 2
MedDRA: Extrasystoles, Loss of personal independence in daily activities, Ventricular extrasystoles — Feeling: Fair

Free text: Daily PVCs (ectopic heartbeats) that interfere with my daily life.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-02	Moderna
2	2021-07-31	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-16	Successful 2021-06-23	Participant prefers to complete VAERS report online
2021-06-23	Successful	Participant prefers to complete VAERS report online
2021-08-21	Successful 2021-08-24	Participant prefers to complete VAERS report online
2021-08-28	Successful 2021-08-31	Participant prefers to complete VAERS report online
2021-09-04	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 1

2021-06-07

Systemic reaction (other): Lower resting heart rate than usual

2021-06-08

Systemic reaction (other): Bradycardia, Dizziness, and head pressure

Release 9 — day 7, dose 1

2021-06-09

Systemic reaction (other): Dizziness, Menstrual Period started 2 days ago and has been very abnormally light

Release 9 — day 14, dose 1

2021-06-16

Symptoms: I have developed POTS (postural tachycardia), had a SVT episode last night, & Im lightheaded and intensely dizzy every day. I get bouts of nausea, Ive lost 6 pounds in a week, and I am exhausted every day. My sleep is significantly disturbed.

Healthcare visit (other): Seeing my primary next week and hopefully neurology after that.

Release 9 — day 21, dose 1

2021-06-23

Symptoms: Low TSH level, raised blood pressure, postural tachycardia (POTS), 99.1 temperature (Im always 97.4-97.6) and fatigue.

Release 9 — day 28, dose 1

2021-07-02

Symptoms: I continue to suffer from symptoms of postural Orthostatic tachycardia syndrome (POTS) but developed excessive ectopic heartbeats, and intense left neck, left upper arm, and left upper back pain.

Release 9 — days 1–6 daily, dose 2

2021-08-01

Systemic reaction (other): Chest pain off and on, right eyelid twitching off and on, tachycardia, POTS

2021-08-03

Systemic reaction (other): Chest pains, chest tightness, indigestion, anxiety attack

2021-08-04

Systemic reaction (other): Dizziness on and off

2021-08-05

Systemic reaction (other): POTS symptoms (tachycardia upon standing/walking)

2021-08-06

Systemic reaction (other): POTS (tachycardia on standing), and ectopic heartbeats when exerting myself

Release 9 — day 7, dose 2

2021-08-07

Systemic reaction (other): POTS (postural tachycardia) and bradycardia when sleeping

Release 9 — day 14, dose 2

2021-08-14

Symptoms: Pulsation in neck that is visible and neck tightness. This has been going on for almost 2 weeks.

Release 9 — day 21, dose 2

2021-08-21

Symptoms: Neck pain around my carotid artery area that started after I got the second vaccine. I have a doctors appt in 2 days to get it checked out.

Release 9 — day 28, dose 2

2021-08-28

Symptoms: Veins in neck pulsate. Doctor concerned about vein distention that did not exist prior to the shot.

Release 9 — day 35, dose 2

2021-09-04

Symptoms: Thyroid issues, POTS (postural Orthostatic tachycardia syndrome), and PVCs/PACs on exertion.

Release 10 — 3 months, dose 2

2021-11-01

Symptoms: Daily PVCs (ectopic heartbeats) that interfere with my daily life.

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	Unevaluable event	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Blood pressure increased	✓	·	✓
SD	Blood thyroid stimulating hormone decreased	✓	·	✓
SD	Body temperature increased	✓	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Extrasystoles	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypertension	○	✓	○
SD	Loss of personal independence in daily activities	·	·	✓
SD	Muscle tightness	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Postural orthostatic tachycardia syndrome	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pulse abnormal	✓	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Supraventricular extrasystoles	✓	·	✓
SD	Supraventricular tachycardia	✓	✓	✓
SD	Thyroid disorder	✓	·	✓
SD	Thyroid hormones decreased	○	✓	○
SD	Vasodilatation	✓	·	✓
SD	Ventricular extrasystoles	✓	·	✓
SD	Weight decreased	✓	✓	✓
SRO	Anxiety	✓	·	✓
SRO	Blepharospasm	✓	·	✓
SRO	Bradycardia	✓	✓	✓
SRO	Chest discomfort	✓	·	✓
SRO	Chest pain	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspepsia	✓	·	✓
SRO	Extrasystoles	✓	·	✓
SRO	Head discomfort	✓	✓	✓
SRO	Heart rate decreased	✓	✓	✓
SRO	Menstrual disorder	✓	✓	✓
SRO	Postural orthostatic tachycardia syndrome	✓	·	✓
SRO	Tachycardia	✓	·	✓

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