5QW-33314-64490

3 vaccinations 10 coded responses 36 check-ins 10 free-text entries 2 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 631 / MO
Registered: 2021-01-27

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

2021-01-27
Registered in v-safe
2021-01-27
Dose 1 — Moderna
2021-01-27
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Headache

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

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 7, dose 1
Feeling: Good · Nausea

Adult check-in
2021-02-10
Survey response — day 14, dose 1
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node at collar bone on same side as injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-24
Dose 2 — Moderna
2021-02-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
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: Heart rate increased — Feeling: Good · Site: Pain

Free text: Heart rhythm abnormal

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: Arrhythmia, Palpitations — Feeling: Fair · Fatigue or tiredness

Free text: Heart rhythm seems weird. Dramatic thumping.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Flatulence, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Winded and heart palpations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 35, dose 2
MedDRA: Arrhythmia, Ventricular extrasystoles — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cardiac PVCHeart rhythm is uneven.Had echo cardio and heart monitor test. Never had it before the second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-29
Survey response — 3 months, dose 2
MedDRA: Arrhythmia, Cardiac monitoring abnormal, Cardiac stress test abnormal, Dyspnoea, Palpitations — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath, heart palpitations. I had this starting 3 days after my second shot near end of February. It has only abate a little bit. Ive had stress test and heart monitor and they have confirmed an arymthia that was not present on ekg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-02
Dose 3 — Pfizer-BioNTech
2021-12-06
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate irregular, Palpitations, Vaccine positive rechallenge — Feeling: Fair · Fatigue or tiredness

Free text: Heart palpitations and irregular heart beat ever since 2nd moderna shot in February . It's worsened since 3rd this time Pfizer shot but hope it will subside

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate irregular, Palpitations — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Heart palpitations and irregular heart beat

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate irregular, Palpitations — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Heart palpitations, irregular heartbeat, irb

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-09
Survey response — day 7, dose 3
MedDRA: Heart rate irregular, Palpitations — Feeling: Fair

Free text: Heart palpitations, irregular heart beat

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Call 1 — Left Voicemail
2021-12-09
Call successful
Participant prefers to complete VAERS report online
2021-12-18
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-25
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-30
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-06
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-14
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-05
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-12-02	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-10

Symptoms: Swollen lymph node at collar bone on same side as injection site.

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Heart rhythm abnormal

2021-02-28

Systemic reaction (other): Heart rhythm seems weird. Dramatic thumping.

Release 5 — day 14, dose 2

2021-03-10

Symptoms: Winded and heart palpations

Release 6 — day 35, dose 2

2021-03-31

Symptoms: Cardiac PVCHeart rhythm is uneven.Had echo cardio and heart monitor test. Never had it before the second shot.

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Shortness of breath, heart palpitations. I had this starting 3 days after my second shot near end of February. It has only abate a little bit. Ive had stress test and heart monitor and they have confirmed an arymthia that was not present on ekg

Release 10 — days 1–6 daily, dose 3

2021-12-06

Systemic reaction (other): Heart palpitations and irregular heart beat ever since 2nd moderna shot in February . It's worsened since 3rd this time Pfizer shot but hope it will subside

2021-12-07

Systemic reaction (other): Heart palpitations and irregular heart beat

2021-12-08

Systemic reaction (other): Heart palpitations, irregular heartbeat, irb

Release 10 — day 7, dose 3

2021-12-09

Systemic reaction (other): Heart palpitations, irregular heart beat

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	Arrhythmia	✓	✓	✓
SD	Cardiac monitoring abnormal	✓	✓	✓
SD	Cardiac stress test abnormal	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Flatulence	✓	✓	○
SD	Lymphadenopathy	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Ventricular extrasystoles	✓	✓	✓
SRO	Arrhythmia	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Heart rate irregular	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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