ZN9-11094-43749

3 vaccinations 7 coded responses 24 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 444 / OH
Registered: 2021-01-06

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

Timeline

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Survey response — day 0, dose 1
MedDRA: Heart rate increased — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Made my heart beat rapidly for a bit but now it good.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I didn't have chills but there was a constant coolness to my body since the shot. I'm normally a heater always warm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Coldness but not chills.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-01-20
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Moderna
2021-02-03
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Ear discomfort, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Heart pulsing in my ears. Arthritic in my fingers hand and elbiw

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-24
Survey response — day 21, dose 2
MedDRA: Bowel movement irregularity, Headache, Heart rate increased — Feeling: Fair

Free text: Servere headache and rapid heart beat and multiple bowel moments without diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-17
Dose 3 — Moderna
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Arrhythmia, Fatigue, Malaise, Tachycardia — Feeling: Fair · Be unable to do your normal daily activities

Free text: I keep going into tachycardia because My arrhythmia has been off ever since I got all the shots. I'm tired all the time and I always feel like I'm coming down with something.

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Survey response — 12 months, dose 3
MedDRA: Anxiety, Condition aggravated, Depression, Heart rate decreased, Illness, Immunodeficiency, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Heart beats now drop to 45. I had arrhythmia problem before and now they're worse. I get other sicknesses quicker. It kind of made me immune compromised. And I developed severe anxiety and depression and now I'm medicated. · Healthcare visit (other): Normal appointment

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna
3	2021-12-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-18	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-06

Systemic reaction (other): Made my heart beat rapidly for a bit but now it good.

Release 1 — days 1–6 daily, dose 1

2021-01-08

Systemic reaction (other): I didn't have chills but there was a constant coolness to my body since the shot. I'm normally a heater always warm.

2021-01-09

Systemic reaction (other): Coldness but not chills.

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Heart pulsing in my ears. Arthritic in my fingers hand and elbiw

Release 4 — day 21, dose 2

2021-02-24

Symptoms: Servere headache and rapid heart beat and multiple bowel moments without diarrhea

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: I keep going into tachycardia because My arrhythmia has been off ever since I got all the shots. I'm tired all the time and I always feel like I'm coming down with something.

Release 12 — 12 months, dose 3

2022-12-18

Symptoms: Heart beats now drop to 45. I had arrhythmia problem before and now they're worse. I get other sicknesses quicker. It kind of made me immune compromised. And I developed severe anxiety and depression and now I'm medicated.

Healthcare visit (other): Normal appointment

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	Office visit	·	·	✓
SD	Anxiety	·	·	✓
SD	Arrhythmia	·	·	✓
SD	Bowel movement irregularity	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Depression	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Heart rate decreased	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Illness	·	·	✓
SD	Immunodeficiency	·	·	✓
SD	Malaise	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Tachycardia	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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