YK4-31407-42893
4 vaccinations
6 coded responses
27 check-ins
6 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 499 / MI
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Registered in v-safe
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2021-01-22
Dose 1 — Moderna
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2021-01-22
Survey response — day 0, dose 1MedDRA: Heart rate increased — Feeling: GoodFree text: 4 hours after my heart took off and stayed at 140 bpm for nearly an hourMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-24
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2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate increased — Feeling: GoodFree text: My resting heart rate shot up shortly after going to bed, from 60s to low to mid 130s. Last night this may have lasted over 2 hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate increased, Medical counselling, Supraventricular tachycardia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: At 5 a.m. my heart took off for better than 4 hours. Download from Medtronic device by my heart doctor suggests probable SVT on 24th, 24th and today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-27
- 2021-01-28
- 2021-01-29
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2021-02-05
Survey response — day 14, dose 1MedDRA: Heart rate increased, Palpitations, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Racing heart more frequent. 135-145 bpm. Have appt with electrophysiologist next week · Healthcare visit (other): Appt this coming weekMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-12
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2021-02-19
Dose 2 — Moderna
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
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2021-03-26
Survey response — day 35, dose 2MedDRA: Palpitations — Feeling: GoodFree text: Racing heart episodesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-10
- 2021-04-14
- 2021-04-19
- 2021-05-21
- 2021-08-20
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2021-11-22
Dose 3 — Moderna
- 2022-02-19
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2022-05-23
Survey response — 6 months, dose 3MedDRA: Tooth infection — 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 consultationFree text: Infected toothMedDRA releases: 2024-11 · check-in free text available
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2022-05-23
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-24
- 2022-05-24
- 2022-05-24
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2022-09-30
Dose 4 — ModernaCo-administered: Flu
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2022-09-30 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-26 | Unsuccessful | |
| 2021-02-05 | Unsuccessful | |
| 2022-05-23 | Unsuccessful |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): 4 hours after my heart took off and stayed at 140 bpm for nearly an hour
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My resting heart rate shot up shortly after going to bed, from 60s to low to mid 130s. Last night this may have lasted over 2 hours
Systemic reaction (other): At 5 a.m. my heart took off for better than 4 hours. Download from Medtronic device by my heart doctor suggests probable SVT on 24th, 24th and today.
Release 3 — day 14, dose 1
Symptoms: Racing heart more frequent. 135-145 bpm. Have appt with electrophysiologist next week
Healthcare visit (other): Appt this coming week
Release 6 — day 35, dose 2
Symptoms: Racing heart episodes
Release 11 — 6 months, dose 3
Symptoms: Infected tooth
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 | Heart rate increased | ✓ | · | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Tooth infection | · | · | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Medical counselling | ✓ | ✓ | ○ |
| SRO | Supraventricular tachycardia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release