5PR-13134-71961

2 vaccinations 13 coded responses 23 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 274 / NC
Registered: 2021-02-01

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

2021-01-29
Dose 1 — Moderna
2021-02-01
Registered in v-safe
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Free text: Rash seems to be around an inch or 2 below injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Injection site erythema, Nausea, Tachycardia — Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Free text: The day I got my Moderna vaccine 1-29 I experienced tachycardia about 2 hours after my injection.I do have a history of tachycardia so I dont know how to tell if it was a result of the vaccine, heart rate went to 202 for a short time. Then on the next day I had a headache, nauseated, temperature of 99.8 then a day later the red area about an inch below the injection site turned red and is still red today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Oral disorder — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: I noticed a small bump inside my mouth on right side, also got my vaccine in right arm. I am mentioning this since I read some had bump in their arm pit of arm that they received shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-12
Survey response — day 14, dose 1
MedDRA: Tachycardia — Feeling: Good · Be unable to do your normal daily activities

Free text: I have a question. I had my first Moderna vaccine on 1/29. I had tachycardia 202 beats per minute about an hour after my first Moderna shot. The tachycardia lasted a few minutes. Should I get my second vaccine on 3/1 ?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 21, dose 1
MedDRA: Tachycardia — Feeling: Good

Free text: I had tachycardia 220bpm about an hour after my first vaccine and no one has gotten back with me and I dont know if it is ok for me to get 2nd shot on 3/1 (b)(6) can someone call or advise me (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Survey response — day 0, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Sore arm from injection - mild

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: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Free text: Severe

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: Injection site warmth — Feeling: Good · Site: Redness, Swelling

Free text: Warm at injection site- moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site warmth — Feeling: Good · Site: Redness, Swelling · Nausea

Free text: Warm at injection site-mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — day 14, dose 2
MedDRA: Chills, Headache — Feeling: Fair

Free text: HeadacheChills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 21, dose 2
MedDRA: Office visit, Stomatitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Sores in roof of mouth · Healthcare visit (other): Dentist and Dermatologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Survey response — day 28, dose 2
MedDRA: Herpes zoster, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Possible shingles · Healthcare visit (other): Drs office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-12
Call successful
Participant prefers to complete VAERS report online
2022-03-03
Survey response — 12 months, dose 2
MedDRA: Office visit, Reaction to previous exposure to any vaccine, Tachycardia — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: After my first Moderna vaccine in Jan 2021 my heart rate went to 202 an hour after receiving shot. I got my 2nd Moderna shot 3/2021. I continue to have episodes of tachycardia. I did not get Booster. · Healthcare visit (other): Went to pcp for consultation

MedDRA releases: 2024-11 · check-in free text available
2022-03-03
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-04
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-03-01	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): Rash seems to be around an inch or 2 below injection site

2021-02-02

Systemic reaction (other): The day I got my Moderna vaccine 1-29 I experienced tachycardia about 2 hours after my injection.I do have a history of tachycardia so I dont know how to tell if it was a result of the vaccine, heart rate went to 202 for a short time. Then on the next day I had a headache, nauseated, temperature of 99.8 then a day later the red area about an inch below the injection site turned red and is still red today.

2021-02-03

Systemic reaction (other): I noticed a small bump inside my mouth on right side, also got my vaccine in right arm. I am mentioning this since I read some had bump in their arm pit of arm that they received shot.

Release 4 — day 14, dose 1

2021-02-12

Symptoms: I have a question. I had my first Moderna vaccine on 1/29. I had tachycardia 202 beats per minute about an hour after my first Moderna shot. The tachycardia lasted a few minutes. Should I get my second vaccine on 3/1 ?

Release 4 — day 21, dose 1

2021-02-19

Symptoms: I had tachycardia 220bpm about an hour after my first vaccine and no one has gotten back with me and I dont know if it is ok for me to get 2nd shot on 3/1 (b)(6) can someone call or advise me (b)(6)

redacted (b)(6)

Release 4 — day 0, dose 2

2021-03-01

Systemic reaction (other): Sore arm from injection - mild

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Severe

2021-03-03

Systemic reaction (other): Warm at injection site- moderate

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Warm at injection site-mild

Release 5 — day 14, dose 2

2021-03-15

Symptoms: HeadacheChills

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Sores in roof of mouth

Healthcare visit (other): Dentist and Dermatologist

Release 6 — day 28, dose 2

2021-03-29

Symptoms: Possible shingles

Healthcare visit (other): Drs office

Release 11 — 12 months, dose 2

2022-03-03

Symptoms: After my first Moderna vaccine in Jan 2021 my heart rate went to 202 an hour after receiving shot. I got my 2nd Moderna shot 3/2021. I continue to have episodes of tachycardia. I did not get Booster.

Healthcare visit (other): Went to pcp for consultation

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	Chills	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Stomatitis	✓	✓	✓
SD	Tachycardia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oral disorder	✓	✓	✓
SRO	Tachycardia	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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