6XZ-16694-34371

2 vaccinations 10 coded responses 20 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 773 / TX
Registered: 2021-02-07

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-06
Dose 1 — Moderna
2021-02-07
Registered in v-safe
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Previous condition of arrhythmia ongoing since 5 years ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches

Free text: Previous and ongoing arrythmia and ostopenia prior to vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Tachycardia — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Prior health condition, Ongoing tachycardia, 148 beats last night, had to take extra dose of medication to lower down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Previous and ongoing supraventricular tachycardia prior to vaccination, ostopenia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Osteopenia, Pre-existing disease, Supraventricular tachycardia — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Previous and ongoing supraventricular tachycardia, ostopenia prior to vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Muscle or body aches

Free text: Previous and ongoing supraventricular tachycardia prior to caccination, and ostopenia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Dose 2 — Moderna
2021-03-06
Survey response — day 0, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Ongoing and previous condition of ventricular tachycardia: osteopoenia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased, Palpitations — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Palpitations more frequent than I used to have, higher heart rate than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased, Tachycardia — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Tachycardia and higher heart rate is still being experienced today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Tachycardia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Tachycardia and osteopoenia ongoing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-06	Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-07

Systemic reaction (other): Previous condition of arrhythmia ongoing since 5 years ago

2021-02-08

Systemic reaction (other): Previous and ongoing arrythmia and ostopenia prior to vaccination

2021-02-09

Systemic reaction (other): Prior health condition, Ongoing tachycardia, 148 beats last night, had to take extra dose of medication to lower down

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Previous and ongoing supraventricular tachycardia prior to vaccination, ostopenia

2021-02-11

Systemic reaction (other): Previous and ongoing supraventricular tachycardia, ostopenia prior to vaccination

2021-02-12

Systemic reaction (other): Previous and ongoing supraventricular tachycardia prior to caccination, and ostopenia

Release 5 — day 0, dose 2

2021-03-06

Systemic reaction (other): Ongoing and previous condition of ventricular tachycardia: osteopoenia

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Palpitations more frequent than I used to have, higher heart rate than usual

2021-03-08

Systemic reaction (other): Tachycardia and higher heart rate is still being experienced today

2021-03-09

Systemic reaction (other): Tachycardia and osteopoenia ongoing

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
SRO	Condition aggravated	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Osteopenia	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Supraventricular tachycardia	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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