6BB-16242-38000

4 vaccinations 15 coded responses 29 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 945 / CA
Registered: 2021-03-21

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

2021-03-18
Dose 1 — Moderna
2021-03-21
Registered in v-safe
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose fluctuation — Feeling: Good

Free text: Im having trouble regulating my blood sugar, as if my medication is behaving differently since the injection. Not serious but noticeable.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Body temperature increased, Nausea, Oral herpes — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: My body temp jumped last evening at the peak of what seems to be repeated evening nausea. It went high enough to cause a fever blister.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Good · Nausea

Free text: I previously reported nausea and erratic heartbeat that I now realize may have been due to the introduction of a new glucose control medication.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 21, dose 1
MedDRA: Heart rate irregular, Ventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: On the fourth day after the shot I started to experience an erratic heart beat (now diagnosed as PVC's) I didn't even think about a possible connection but saw a cardiologist yesterday that said it couldn't be ruled out. This will not stop me from #2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

no matching call case
2021-04-15
Survey response — day 28, dose 1
MedDRA: Heart rate irregular, Office visit — Feeling: Good

Free text: Continued irregular heart rhythm. Now wearing a heart monitor after a cardiologist visit. Symptoms began 72 hours after first vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Dose 2 — Moderna
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Some minor heartbeat irregularities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

Free text: Irregular heart beats. They had subsided to almost nothing 3 weeks after the first injection but were back today more than before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Good

Free text: Irregular heartbeats that began in earnest yesterday are still with me but a bit less. I am currently wearing a heart monitor since the irregularity began after the first dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Good

Free text: Irregular heartbeats are fewer today. They were at their worst Friday evening/night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Good

Free text: Continued but lessening irregular heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 7, dose 2
MedDRA: Heart rate irregular — Feeling: Good

Free text: Still having occasional irregular heartbeats but it seems to be lessening a bit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-12
Survey response — day 21, dose 2
MedDRA: Heart rate irregular, Office visit — Feeling: Good

Free text: Continued irregular heartbeat being monitored by a cardiologist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 28, dose 2
MedDRA: Therapeutic response unexpected — Feeling: Good

Free text: Heart rhythm issues (PVCs) are much reduced. Wish I had been warned of this side effect I could have been spared the worry and expense of cardiologist visits, heart monitoring and expensive tests.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 35, dose 2
MedDRA: Arrhythmia, Cardiac monitoring — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Heart rhythm issues are calming down but still occurring. I had what appears to be a normal stress/echo test last week with a standard echo on Monday. I also wore a heart monitor for two weeks prior.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Survey response — day 42, dose 2
MedDRA: Cardiac stress test, Echocardiogram, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I saw the cardiologist for the results of my stress echo, 3-D echo, and 14 day heart monitor. All appear to be normal and palpitations had dissipated to almost nothing by the end of week five. Please get the word out...this is a harmless temp vac s/e

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-28
Dose 3 — Moderna
2022-02-10
Call 1 — Could Not Reach Participant
2022-02-10
Call successful
Does not wish to fill out VAERS report
2022-04-21
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-03
Dose 4 — Moderna
2022-05-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-01
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-03
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-21	Moderna
3	2021-12-28	Moderna	No
4	2022-05-03	Moderna	No

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

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

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Im having trouble regulating my blood sugar, as if my medication is behaving differently since the injection. Not serious but noticeable.

2021-03-24

Systemic reaction (other): My body temp jumped last evening at the peak of what seems to be repeated evening nausea. It went high enough to cause a fever blister.

Release 6 — day 7, dose 1

2021-03-25

Systemic reaction (other): I previously reported nausea and erratic heartbeat that I now realize may have been due to the introduction of a new glucose control medication.

Release 7 — day 21, dose 1

2021-04-08

Symptoms: On the fourth day after the shot I started to experience an erratic heart beat (now diagnosed as PVC's) I didn't even think about a possible connection but saw a cardiologist yesterday that said it couldn't be ruled out. This will not stop me from #2 cut off by CDC

Release 7 — day 28, dose 1

2021-04-15

Symptoms: Continued irregular heart rhythm. Now wearing a heart monitor after a cardiologist visit. Symptoms began 72 hours after first vaccine.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Some minor heartbeat irregularities

2021-04-23

Systemic reaction (other): Irregular heart beats. They had subsided to almost nothing 3 weeks after the first injection but were back today more than before.

2021-04-24

Systemic reaction (other): Irregular heartbeats that began in earnest yesterday are still with me but a bit less. I am currently wearing a heart monitor since the irregularity began after the first dose.

2021-04-25

Systemic reaction (other): Irregular heartbeats are fewer today. They were at their worst Friday evening/night

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Continued but lessening irregular heart beat

Release 8 — day 7, dose 2

2021-04-28

Systemic reaction (other): Still having occasional irregular heartbeats but it seems to be lessening a bit

Release 8 — day 21, dose 2

2021-05-12

Symptoms: Continued irregular heartbeat being monitored by a cardiologist.

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Heart rhythm issues (PVCs) are much reduced. Wish I had been warned of this side effect I could have been spared the worry and expense of cardiologist visits, heart monitoring and expensive tests.

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Heart rhythm issues are calming down but still occurring. I had what appears to be a normal stress/echo test last week with a standard echo on Monday. I also wore a heart monitor for two weeks prior.

Release 8 — day 42, dose 2

2021-06-02

Symptoms: I saw the cardiologist for the results of my stress echo, 3-D echo, and 14 day heart monitor. All appear to be normal and palpitations had dissipated to almost nothing by the end of week five. Please get the word out...this is a harmless temp vac s/e cut off by CDC

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	✓	✓	✓
SD	Cardiac stress test	✓	✓	✓
SD	Echocardiogram	✓	✓	✓
SD	Heart rate irregular	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Therapeutic response unexpected	✓	✓	✓
SD	Ventricular extrasystoles	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Blood glucose fluctuation	✓	✓	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Heart rate irregular	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oral herpes	✓	✓	✓

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