ZQZ-32195-34078

3 vaccinations 11 coded responses 18 check-ins 11 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 107 / NY
Registered: 2021-01-04

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Moderna
2021-01-04
Survey response — day 0, dose 1
MedDRA: Emergency care, Immediate post-injection reaction, Sinus tachycardia — Feeling: Fair · Site: Pain · Chills, Headache · Be unable to work, Be unable to do your normal daily activities

Free text: Right after vaccine I had sinus tachycardia and went to the emergency room

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — day 0, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations, Tachycardia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Heart palpitations intermittently, unlike at the time of injection where my heart rate was tachycardic for a few hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Tachycardia — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: My heart has still had intermittent tachycardia

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 · Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Diarrhea

Free text: Upset stomach since yesterday nothing severe but uncomfortable

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

Adult check-in
2021-01-13
Survey response — day 7, dose 1
MedDRA: Injection site erythema, Injection site indentation, Injection site pain, Injection site pruritus, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Abdominal pain · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I'm 9 days post vaccine and this morning I woke up with a new reaction at injection site. It make no sense why after 9 days the swelling and hard lump would come back and it's red, painful and itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-18
Survey response — day 14, dose 1
MedDRA: Fatigue, Injection site discolouration, Injection site rash, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My injections site has a terrible discoloration and rash , it hot to the touch and tender . Looks similar to a Lymes rash but exact spot of injection and Im still exhausted and achey

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-25
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: Racing hearts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Back pain, Chest pain, Pain, Tachycardia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Random sharp body pains, back, chest , hips. Burst of tachycardia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Burning sensation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle twitching — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Ive had muscle twitching since yesterday mainly in my face but in the limbs as well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — day 7, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-01
Call 1 — Left Voicemail
2021-03-18
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ive had ongoing heart palpitations

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-05
Call 1 — Left Voicemail
2021-12-17
Dose 3 — Moderna

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-02	Moderna
3	2021-12-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-04	Unsuccessful
2021-01-05	Unsuccessful
2021-01-13	Unsuccessful
2021-01-18	Unsuccessful
2021-08-03	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-04

Systemic reaction (other): Right after vaccine I had sinus tachycardia and went to the emergency room

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): Heart palpitations intermittently, unlike at the time of injection where my heart rate was tachycardic for a few hours

2021-01-06

Systemic reaction (other): My heart has still had intermittent tachycardia

2021-01-08

Systemic reaction (other): Upset stomach since yesterday nothing severe but uncomfortable

Release 1 — day 7, dose 1

2021-01-13

Systemic reaction (other): I'm 9 days post vaccine and this morning I woke up with a new reaction at injection site. It make no sense why after 9 days the swelling and hard lump would come back and it's red, painful and itchy.

Release 2 — day 14, dose 1

2021-01-18

Symptoms: My injections site has a terrible discoloration and rash , it hot to the touch and tender . Looks similar to a Lymes rash but exact spot of injection and Im still exhausted and achey

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Racing hearts

2021-02-04

Systemic reaction (other): Random sharp body pains, back, chest , hips. Burst of tachycardia

2021-02-05

Systemic reaction (other): Burning sensation

2021-02-07

Systemic reaction (other): Ive had muscle twitching since yesterday mainly in my face but in the limbs as well

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: Ive had ongoing heart palpitations

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
SD	Fatigue	✓	✓	✓
SD	Injection site discolouration	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Palpitations	✓	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site indentation	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Muscle twitching	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Sinus tachycardia	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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