5G5-29943-32224

4 vaccinations 14 coded responses 43 check-ins 14 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 500 / IA
Registered: 2021-01-26

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

2021-01-25
Dose 1 — Moderna
2021-01-26
Registered in v-safe
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Atrial fibrillation — Feeling: Good

Free text: At approximately 1:30 on 1/26 I went into a fib for about 24 hours, dont think it was related to vaccines.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Good · Chills, Muscle or body aches

Free text: Day after first shot and second shot heart went into a fib.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Good

Free text: Continued a fib today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Good

Free text: Third day of afib.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Good

Free text: Third day with afib.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Good

Free text: Fourth day afib.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Atrial fibrillation — Feeling: Good

Free text: Fifth day of being in afib. Long than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Atrial fibrillation — Feeling: Good

Free text: Stayed in afib longer than normal

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — day 35, dose 3
MedDRA: Atrial fibrillation, Vaccine positive rechallenge — Feeling: Good

Free text: Having afib., afib has lasted considerably long than normal. The same held true for the first two vaccine shots.

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-31
Dose 4 — Moderna
2022-04-09
Survey response — day 7, dose 4
MedDRA: Pre-existing disease, Vertigo — Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: I have minears syndrome and after the injection my vertigo has exacerbated.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Survey response — day 14, dose 4
MedDRA: Vertigo — Feeling: Good · Be unable to do your normal daily activities

Free text: Had three episodes of vertigo since my second booster injection.

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Survey response — day 21, dose 4
MedDRA: Ear discomfort, Vertigo, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Vertigo and vomiting- fullness in the ear

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Survey response — day 28, dose 4
MedDRA: Balance disorder, Vertigo — Feeling: Fair · Be unable to do your normal daily activities

Free text: Periodic vertigo and balance issues

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Survey response — 3 months, dose 4
MedDRA: Meniere's disease, Office visit, Pre-existing disease — 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

Free text: Symptoms: Mnire's disease attacks. Less attacks than right after boosters. · Healthcare visit (other): Specialist

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-07-01
Call successful
Does not wish to fill out VAERS report
2022-09-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-03-31
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-02-25	Moderna
3	2021-10-22	Moderna	No
4	2022-03-31	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): At approximately 1:30 on 1/26 I went into a fib for about 24 hours, dont think it was related to vaccines.

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Day after first shot and second shot heart went into a fib.

2021-02-28

Systemic reaction (other): Continued a fib today

2021-03-01

Systemic reaction (other): Third day of afib.

2021-03-02

Systemic reaction (other): Third day with afib.

2021-03-03

Systemic reaction (other): Fourth day afib.

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): Fifth day of being in afib. Long than usual.

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): Stayed in afib longer than normal

Release 10 — day 35, dose 3

2021-11-26

Symptoms: Having afib., afib has lasted considerably long than normal. The same held true for the first two vaccine shots.

Release 11 — day 7, dose 4

2022-04-09

Systemic reaction (other): I have minears syndrome and after the injection my vertigo has exacerbated.

Release 11 — day 14, dose 4

2022-04-14

Symptoms: Had three episodes of vertigo since my second booster injection.

Release 11 — day 21, dose 4

2022-04-21

Symptoms: Vertigo and vomiting- fullness in the ear

Release 11 — day 28, dose 4

2022-04-28

Symptoms: Periodic vertigo and balance issues

Release 12 — 3 months, dose 4

2022-06-30

Symptoms: Mnire's disease attacks. Less attacks than right after boosters.

Healthcare visit (other): Specialist

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	Office visit	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Balance disorder	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Meniere's disease	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SD	Vertigo	·	·	✓
SD	Vomiting	·	·	✓
SRO	Atrial fibrillation	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Vertigo	·	·	✓

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