55N-31587-76642
1 vaccination
4 coded responses
13 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 757 / TX
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Registered in v-safe
-
2021-01-16
Dose 1 — Moderna
- 2021-01-16
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · 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
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2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-19
- 2021-01-22
- 2021-01-23
- 2021-01-30
- 2021-02-07
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2021-02-13
Survey response — day 28, dose 1MedDRA: Cough, Dyspnoea, Hospitalisation, Ventricular tachycardia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: I had Ventriculartackacardia and was in the hospital unable to breath for 2 days, and was unable to get the shot. I got home last night, after my shot appointment. I also have a bad cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Survey response — day 35, dose 1MedDRA: Atrial fibrillation, Cardioversion, Cough, Hospitalisation, Respiratory distress, Ventricular tachycardia — 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: Bad cough, ventricular tachacardia, extremely distressed breathing, hospitalized for 2 days, Afib, heart rate 130-140. Got prepped for cardioversion and heart went into normal sinus rhythm. Missed my second vaccine, Was released and went homeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Report sent to call center — day 35, dose 1Be 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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2021-02-27
Survey response — day 42, dose 1MedDRA: Atrial fibrillation, Cough, Fatigue — Feeling: FairFree text: Increased Afib, lasting for several days at a time, even while on the increased Sotalol medication. When I am in Afib that long, even 1/2 a day, fatigue sets in and I am exhausted.I have also got the cough I had, when I had the covid, that came back.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
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2021-07-17
Survey response — 6 months, dose 1MedDRA: Atrial fibrillation, Cardiac operation — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Bad Afib, too much sotolol to function properly. Chose to have a Wolf Minimaze. In 4th week right now following surgery.Doing much better!.MedDRA releases: 2024-11 · check-in free text available
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2021-07-17
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-21
- 2021-07-24
- 2022-01-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna |
Call center
3 call center cases
2 unsuccessful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 4 — day 28, dose 1
Symptoms: I had Ventriculartackacardia and was in the hospital unable to breath for 2 days, and was unable to get the shot. I got home last night, after my shot appointment. I also have a bad cough.
Release 4 — day 35, dose 1
Symptoms: Bad cough, ventricular tachacardia, extremely distressed breathing, hospitalized for 2 days, Afib, heart rate 130-140. Got prepped for cardioversion and heart went into normal sinus rhythm. Missed my second vaccine, Was released and went home
Release 4 — day 42, dose 1
Symptoms: Increased Afib, lasting for several days at a time, even while on the increased Sotalol medication. When I am in Afib that long, even 1/2 a day, fatigue sets in and I am exhausted.I have also got the cough I had, when I had the covid, that came back. cut off by CDC
Release 9 — 6 months, dose 1
Symptoms: Bad Afib, too much sotolol to function properly. Chose to have a Wolf Minimaze. In 4th week right now following surgery.Doing much better!.
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 | Atrial fibrillation | ✓ | ✓ | ✓ |
| SD | Cardiac operation | · | · | ✓ |
| SD | Cardioversion | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Respiratory distress | ✓ | ✓ | ✓ |
| SD | Tachycardia | ○ | ○ | ○ |
| SD | Ventricular tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release