5BU-14206-89781
2 vaccinations
3 coded responses
12 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 272 / NC
- Registered
- 2021-06-02
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-04
Dose 1 — Moderna
-
2021-06-01
Dose 2 — Moderna
-
2021-06-02
Registered in v-safe
-
2021-06-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationAdult check-in
-
2021-06-02
Report sent to call center — days 1–6 daily, 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)
-
2021-06-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-06-04
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Heart palpitationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-05
- 2021-06-06
- 2021-06-07
- 2021-06-08
- 2021-06-10
-
2021-06-10
Call successfulParticipant prefers to complete VAERS report online
- 2021-06-15
-
2021-06-22
Survey response — day 21, dose 2MedDRA: Arrhythmia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: ArrhythmiasMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-22
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-24
-
2021-07-01
Survey response — day 28, dose 2MedDRA: Dizziness, Syncope, Unevaluable event, Ventricular extrasystoles — Feeling: Fair · 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, Emergency room or emergency department visitFree text: Symptoms: Vasovagal syncope on Monday , June 28. Following days have experienced dizziness/wooziness and increased PVCs. · Healthcare visit (other): Cardiology visit tomorrow 7/2MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-01
Report sent to call center — day 28, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-07-06
-
2021-07-07
Call successfulParticipant prefers to complete VAERS report online
- 2021-07-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-04 | Moderna | |
| 2 | 2021-06-01 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-02 | Successful 2021-06-10 |
Participant prefers to complete VAERS report online |
| 2021-06-22 | Successful | Participant prefers to complete VAERS report online |
| 2021-07-01 | Successful 2021-07-07 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Heart palpitations
Release 9 — day 21, dose 2
Symptoms: Arrhythmias
Release 9 — day 28, dose 2
Symptoms: Vasovagal syncope on Monday , June 28. Following days have experienced dizziness/wooziness and increased PVCs.
Healthcare visit (other): Cardiology visit tomorrow 7/2
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 | Arrhythmia | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Syncope | ✓ | ✓ | ✓ |
| SD | Ventricular extrasystoles | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release