ZLM-19890-61134
2 vaccinations
6 coded responses
26 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 496 / MI
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Registered in v-safe
-
2021-03-12
Dose 1 — Moderna
- 2021-03-12
-
2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · HeadacheAdult check-in
- 2021-03-14
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Bone pain — Feeling: Good · Site: Pain · Joint painsFree text: Shin bones and upper arm bones ache. Started yesterday after already responding to the daily survey. Dont know if bone pain is related to the vaccinne or notMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
-
2021-04-09
Dose 2 — Moderna
- 2021-04-09
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2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature fluctuation — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Got various readings on temp within a seconds of each other. Ranged from 100.00 on 1st reading and 98.5 and 86.9 and 98.3MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
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2021-04-23
Survey response — day 14, dose 2MedDRA: Sinusitis — Feeling: GoodFree text: Sinus infection for aprox 1 week. Probably due to weather. I think it's gone now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-30
Survey response — day 21, dose 2MedDRA: Dizziness, Palpitations — Feeling: Good · Be unable to do your normal daily activitiesFree text: Yesterday evening experienced lightheadness and felt like heart palpatations. As long as I laid down and put my feet up, I was ok. Perfectly fine today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-07-09
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2021-10-08
Survey response — 6 months, dose 2MedDRA: Lower respiratory tract infection, Sinus headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Bad sinus headache on Sept 26 & 27. Bad chest cold Sept 30th thru today Oct 8.MedDRA releases: 2024-11 · check-in free text available
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2022-04-09
Survey response — 12 months, dose 2MedDRA: Atrial fibrillation, Hospitalisation, Office visit, Palpitations, Supraventricular tachycardia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Approx 1 or 2 weeks after receiving 2nd vaccine I began experiencing racing heart. I have been diagnosed with AFIB and Supraventricular Tachycardia. · Healthcare visit (other): After ER and being admitted for 1 day, I have seen a cardiologist and an Electrophysiologist.MedDRA releases: 2024-11 · check-in free text available
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2022-04-09
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-04-13
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-09 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-09 | Successful 2022-04-13 |
Not applicable - Accidental Reporting |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Shin bones and upper arm bones ache. Started yesterday after already responding to the daily survey. Dont know if bone pain is related to the vaccinne or not
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Got various readings on temp within a seconds of each other. Ranged from 100.00 on 1st reading and 98.5 and 86.9 and 98.3
Release 7 — day 14, dose 2
Symptoms: Sinus infection for aprox 1 week. Probably due to weather. I think it's gone now.
Release 8 — day 21, dose 2
Symptoms: Yesterday evening experienced lightheadness and felt like heart palpatations. As long as I laid down and put my feet up, I was ok. Perfectly fine today.
Release 10 — 6 months, dose 2
Symptoms: Bad sinus headache on Sept 26 & 27. Bad chest cold Sept 30th thru today Oct 8.
Release 11 — 12 months, dose 2
Symptoms: Approx 1 or 2 weeks after receiving 2nd vaccine I began experiencing racing heart. I have been diagnosed with AFIB and Supraventricular Tachycardia.
Healthcare visit (other): After ER and being admitted for 1 day, I have seen a cardiologist and an Electrophysiologist.
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 | Hospitalisation | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Lower respiratory tract infection | · | · | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SD | Supraventricular tachycardia | · | · | ✓ |
| SRO | Body temperature fluctuation | ✓ | ✓ | ✓ |
| SRO | Bone pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release