6HD-12157-02282 · OpenVSafe

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-10-05
Dose 1 — Moderna
2021-12-03
Dose 2 — Moderna
2021-12-16
Registered in v-safe
2021-12-16
Survey response — day 7, dose 2
MedDRA: Angina pectoris — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: heart pain in the chest especially if I walk vigorously or lift heavy items

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — day 14, dose 2
MedDRA: Body temperature increased, Chills, Influenza — Feeling: Poor · Be unable to work or attend school

Free text: Stomach flu symptoms, chills again, and slight fever 100.1

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Survey response — day 28, dose 2
MedDRA: Atrial fibrillation, Balance disorder, Chest pain, Extrasystoles, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: The pain in my right arm gets really painful, also have pain in my chest, due to additional heart beats. The ejection rate has to pump an additional pump to remove blood that pools in the one chamber to the next. Balance issue as well

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Survey response — day 35, dose 2
MedDRA: Angina pectoris, Ejection fraction abnormal — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still experiencing ejection rate issues with heart. Painful heart beats. Cannot exert myself without pain.

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-05	Moderna	No
2	2021-12-03	Moderna	No

Free text

Release 10 — day 7, dose 2

2021-12-16

Systemic reaction (other): heart pain in the chest especially if I walk vigorously or lift heavy items

Release 10 — day 14, dose 2

2021-12-17

Symptoms: Stomach flu symptoms, chills again, and slight fever 100.1

Release 10 — day 28, dose 2

2021-12-31

Symptoms: The pain in my right arm gets really painful, also have pain in my chest, due to additional heart beats. The ejection rate has to pump an additional pump to remove blood that pools in the one chamber to the next. Balance issue as well

Release 10 — day 35, dose 2

2022-01-07

Symptoms: Still experiencing ejection rate issues with heart. Painful heart beats. Cannot exert myself without pain.

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	Angina pectoris	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Balance disorder	·	·	✓
SD	Body temperature increased	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Ejection fraction abnormal	·	·	✓
SD	Extrasystoles	·	·	✓
SD	Influenza	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Angina pectoris	·	·	✓

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