G3B-31172-15183
2 vaccinations
3 coded responses
25 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 018 / MA
- Registered
- 2021-02-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-16
Registered in v-safe
-
2021-02-16
Dose 1 — Moderna
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
-
2021-03-09
Survey response — day 21, dose 1MedDRA: Emergency care, Heart rate increased, Unevaluable event — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Symptoms: I had to take an ambulance to the hospital for a rapid heartbeat. Im currently in the process of tests and appts to determine the cause. · Healthcare visit (other): CT scan, bloodwork, EKGMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Report sent to call center — day 21, dose 1Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-16
Dose 2 — Moderna
- 2021-03-16
-
2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, Headache, NauseaAdult check-in
-
2021-03-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · HeadacheAdult check-in
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-15
- 2021-04-20
-
2021-04-27
Survey response — day 42, dose 2MedDRA: Hypopnoea, Palpitations — Feeling: Good · Be unable to do your normal daily activitiesFree text: Heart palpitations, shallow breathingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-17
- 2021-09-14
-
2021-12-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-03-18
Survey response — 12 months, dose 2MedDRA: Hypertension, Pregnancy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: High blood pressure, pregnancy.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-18
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-21
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-16 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 5 — day 21, dose 1
Symptoms: I had to take an ambulance to the hospital for a rapid heartbeat. Im currently in the process of tests and appts to determine the cause.
Healthcare visit (other): CT scan, bloodwork, EKG
Release 8 — day 42, dose 2
Symptoms: Heart palpitations, shallow breathing
Release 11 — 12 months, dose 2
Symptoms: High blood pressure, pregnancy.
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Hypopnoea | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Pregnancy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release