ZSX-43866-59170
2 vaccinations
7 coded responses
18 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 467 / IN
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-06
Dose 1 — Moderna
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2021-01-07
Registered in v-safe
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2021-01-07
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate increased, Tremor — Feeling: Poor · Site: Pain · Fever · NauseaFree text: Rapid heart rate, shakinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-08
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2021-01-09
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate increased — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesFree text: Heart rate 147MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-09
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-13
- 2021-01-21
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2021-01-27
Survey response — day 21, dose 1MedDRA: Dyspnoea, Heart rate increased, Immediate post-injection reaction, Palpitations — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Heart racing. This first happend right after shot. Then 1day lost vaccine HR 130-150 while resting for 4 hours, couldnt catch breath. Tonight and last night same thing of heart rate high while resting.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-03
Dose 2 — Moderna
- 2021-02-03
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2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
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2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-09
- 2021-02-10
- 2021-02-24
- 2021-03-03
- 2021-03-17
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2021-05-07
Survey response — 3 months, dose 2MedDRA: Headache, Muscle spasms — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Severe headache and muscle crampsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-04
Survey response — 6 months, dose 2MedDRA: Asthenia, Pain, Palpitations, Peripheral swelling — Feeling: FairFree text: More heart palpitations and racing heart and swelling in lower extremities. Generalized weakness and pain. I am a nurse so I do not go to dr unless emergencyMedDRA releases: 2021-09,2024-11 · check-in free text available
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2022-02-03
Survey response — 12 months, dose 2MedDRA: Heart rate increased, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Rapid heart rate over 100 and swelling in bilateral lower extremitiesMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-09 | priority 2/3 |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Rapid heart rate, shakiness
Systemic reaction (other): Heart rate 147
Release 2 — day 21, dose 1
Symptoms: Heart racing. This first happend right after shot. Then 1day lost vaccine HR 130-150 while resting for 4 hours, couldnt catch breath. Tonight and last night same thing of heart rate high while resting.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Light headed
Release 8 — 3 months, dose 2
Symptoms: Severe headache and muscle cramps
Release 9 — 6 months, dose 2
Symptoms: More heart palpitations and racing heart and swelling in lower extremities. Generalized weakness and pain. I am a nurse so I do not go to dr unless emergency
Release 11 — 12 months, dose 2
Symptoms: Rapid heart rate over 100 and swelling in bilateral lower extremities
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 | Asthenia | ✓ | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release