5JG-27915-36050
2 vaccinations
8 coded responses
25 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 013 / MA
- Registered
- 2021-02-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-05
Dose 1 — Moderna
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2021-02-06
Registered in v-safe
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2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: PVCs last night about 10 hours after the vaccine at hours of sleep. I am being worked up for a sudden episode of SVT that occurred 2 weeks ago. Holter monitor negative other than documented benign PVCs last week. Last SVT was 26 years ago after initiation of IV morphine following c-section. Heart rate was over 210 both episodes. No SVT symptoms following the vaccine but markedly increased in frequency of PVCs last night when lying down. No noticeable effect today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Palpitations — Feeling: GoodFree text: A few palpitations last night but far less than the night of the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: Ventricular extrasystoles — Feeling: GoodFree text: No further PVCs notedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
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2021-02-10
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Lightheaded intermittentlyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
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2021-03-05
Dose 2 — Moderna
- 2021-03-05
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2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations, Sleep disorder — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Palpitations last night while sleeping. Took a prn metoprolol and they resolved with HR down to 70-80sMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
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2021-03-12
Survey response — day 7, dose 2MedDRA: Hordeolum — Feeling: Good · Muscle or body achesFree text: Very small eye styMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-26
- 2021-04-04
- 2021-04-09
- 2021-04-16
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2021-06-06
Survey response — 3 months, dose 2MedDRA: Joint swelling, Myalgia, Peripheral swelling, Pityriasis rosea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pityriasia Rosea under both axilla. Also many muscle aches, especially if back as back and legs. Swollen feet/anklesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-06
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-05
- 2021-09-05
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2022-03-05
Survey response — 12 months, dose 2MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: COVID positiveMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-05 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): PVCs last night about 10 hours after the vaccine at hours of sleep. I am being worked up for a sudden episode of SVT that occurred 2 weeks ago. Holter monitor negative other than documented benign PVCs last week. Last SVT was 26 years ago after initiation of IV morphine following c-section. Heart rate was over 210 both episodes. No SVT symptoms following the vaccine but markedly increased in frequency of PVCs last night when lying down. No noticeable effect today.
Systemic reaction (other): A few palpitations last night but far less than the night of the vaccine.
Systemic reaction (other): No further PVCs noted
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Lightheaded intermittently
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Palpitations last night while sleeping. Took a prn metoprolol and they resolved with HR down to 70-80s
Release 5 — day 7, dose 2
Systemic reaction (other): Very small eye sty
Release 8 — 3 months, dose 2
Symptoms: Pityriasia Rosea under both axilla. Also many muscle aches, especially if back as back and legs. Swollen feet/ankles
Release 11 — 12 months, dose 2
Symptoms: COVID positive
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 | COVID-19 | · | · | ✓ |
| SD | Joint swelling | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pityriasis rosea | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Hordeolum | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Ventricular extrasystoles | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release