6XE-18108-01719

1 vaccination 7 coded responses 7 check-ins 7 free-text entries 7 call cases

Sex: Female
Age at first dose: 21-25
ZIP prefix: 484 / MI
Registered: 2021-04-07

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-04-07
Registered in v-safe
2021-04-07
Dose 1 — Moderna
2021-04-16
Survey response — day 7, dose 1
MedDRA: Asthenia, Office visit, Palpitations, Paraesthesia — Feeling: Poor · Chills, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Heart palpitations, weakness, tingling · Healthcare visit (other): Cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Hypotension, Pre-existing disease, Tachycardia — Feeling: Fair · 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: Moderna totally made my POTS symptoms worse. Worsened tachycardia and lower blood pressure but slowly returning to normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Survey response — day 21, dose 1
MedDRA: Condition aggravated, Office visit, Postural orthostatic tachycardia syndrome — Feeling: Poor · Be unable to work, 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: Symptoms: My POTS has been significantly worse since i got the first shot. I am having another POTS episode/attack today, i most likely will not get the 2nd shot. · Healthcare visit (other): In person emergency visit to see my cardiologist. EKG, heart monitor ultrasound and starting a new medicine for my heart.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Survey response — day 35, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to work, 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: My heart condition, POTS, was significantly worsened after receiving the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — day 35, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-19
Survey response — day 42, dose 1
MedDRA: Chest pain, Emergency care, Hypoaesthesia, Palpitations, Tachycardia — Feeling: Fair · 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, Emergency room or emergency department visit

Free text: Symptoms: Numbness in face and on entire left side of body, chest pains, heart palpitations, tachycardia · Healthcare visit (other): I am now getting rigorous testing done through cardiologist and neurologists. I had to go to the emergency room because the chest pain and numbness was unbearable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — day 42, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-08
Survey response — 6 months, dose 1
MedDRA: Adverse reaction, Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, 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, Emergency room or emergency department visit

Free text: I got myacardia from the shot and it made my POTS worse. Two different cardiologists have confirmed this.

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-10-12
Call successful
Participant prefers to complete VAERS report online
2022-04-09
Survey response — 12 months, dose 1
MedDRA: Condition aggravated, Office visit, Pre-existing disease, Syncope, Tachycardia — Feeling: Good · Be unable to work or attend school, 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, Emergency room or emergency department visit

Free text: Symptoms: I have POTS and receiving the shot significantly worsened it. A year later I still have worsened POTS, but the symptoms have decreased. I have worse tachycardia now and I faint more frequently. · Healthcare visit (other): I have seen several cardiologists in person from this

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Report sent to call center — 12 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Moderna

Call center

7 call center cases

6 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — day 7, dose 1

2021-04-16

Systemic reaction (other): Heart palpitations, weakness, tingling

Healthcare visit (other): Cardiologist

Release 7 — day 14, dose 1

2021-04-21

Symptoms: Moderna totally made my POTS symptoms worse. Worsened tachycardia and lower blood pressure but slowly returning to normal

Release 8 — day 21, dose 1

2021-04-28

Symptoms: My POTS has been significantly worse since i got the first shot. I am having another POTS episode/attack today, i most likely will not get the 2nd shot.

Healthcare visit (other): In person emergency visit to see my cardiologist. EKG, heart monitor ultrasound and starting a new medicine for my heart.

Release 8 — day 35, dose 1

2021-05-12

Symptoms: My heart condition, POTS, was significantly worsened after receiving the vaccine.

Release 8 — day 42, dose 1

2021-05-19

Symptoms: Numbness in face and on entire left side of body, chest pains, heart palpitations, tachycardia

Healthcare visit (other): I am now getting rigorous testing done through cardiologist and neurologists. I had to go to the emergency room because the chest pain and numbness was unbearable

Release 10 — 6 months, dose 1

2021-10-08

Symptoms: I got myacardia from the shot and it made my POTS worse. Two different cardiologists have confirmed this.

Release 11 — 12 months, dose 1

2022-04-09

Symptoms: I have POTS and receiving the shot significantly worsened it. A year later I still have worsened POTS, but the symptoms have decreased. I have worse tachycardia now and I faint more frequently.

Healthcare visit (other): I have seen several cardiologists in person from this

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	Chest pain	✓	✓	✓
HCVO	Emergency care	✓	✓	✓
HCVO	Hypoaesthesia	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Adverse reaction	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Hypotension	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Postural orthostatic tachycardia syndrome	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Syncope	·	·	✓
SD	Tachycardia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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