ZVB-16590-33460

2 vaccinations 18 coded responses 22 check-ins 18 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 280 / NC
Registered: 2021-03-21

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-19
Dose 1 — Moderna
2021-03-21
Registered in v-safe
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate irregular — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Irregular heartbeat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Atrial fibrillation — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: A-Fib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Palpitations — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, hart palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate irregular — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Irregular heartbeat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiac flutter, Heart rate irregular — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Noticeable Irregular heart beat or fluttering.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 7, dose 1
MedDRA: Palpitations, Vomiting — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Vomited twice. Heart palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 14, dose 1
MedDRA: Asthenia, Burning sensation, Fatigue, Hypoaesthesia, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tied and low energy.Numbness and burning in my arms and hands.Heart palpitations.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Feeling weak in the lungs and intermittent irregular heartbeat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation, Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Afib, sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Atrioventricular block, Heart rate irregular

Free text: Irregular heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Irregular heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Irregular heartbeat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Good · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Irregular heartbeat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — day 7, dose 2
MedDRA: Heart rate irregular — Feeling: Good · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Irregular heartbeat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — day 14, dose 2
MedDRA: Arthralgia, Asthenia, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Very weak, tied, aching joints and nausea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 21, dose 2
MedDRA: Asthenia, Atrial fibrillation, Headache, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart palpitations. I have been having intermittent Afib. It normally lasted for between half hour and three hours. Cases weakness and headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 28, dose 2
MedDRA: Fatigue, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tied and Im still getting erratic heart palpitations from time to time.Didnt really have that before the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-18
Survey response — 6 months, dose 2
MedDRA: Back pain, Mobility decreased, Nephrolithiasis, Sciatica — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: So far 12 weeks of back pain and sciatica along with kidney stones. Can't sit down. In absolute agony every day.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-16	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Irregular heartbeat

2021-03-22

Systemic reaction (other): A-Fib

2021-03-23

Systemic reaction (other): Dizziness, hart palpitations

2021-03-24

Systemic reaction (other): Irregular heartbeat

2021-03-25

Systemic reaction (other): Noticeable Irregular heart beat or fluttering.

Release 6 — day 7, dose 1

2021-03-26

Systemic reaction (other): Vomited twice. Heart palpitations

Release 6 — day 14, dose 1

2021-04-02

Symptoms: Very tied and low energy.Numbness and burning in my arms and hands.Heart palpitations.

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Feeling weak in the lungs and intermittent irregular heartbeat

2021-04-18

Systemic reaction (other): Afib, sore throat.

2021-04-20

Systemic reaction (other): Irregular heart beat

2021-04-20

Systemic reaction (other): Irregular heart beat

2021-04-21

Systemic reaction (other): Irregular heartbeat

2021-04-22

Systemic reaction (other): Irregular heartbeat

Release 7 — day 7, dose 2

2021-04-24

Systemic reaction (other): Irregular heartbeat

Release 8 — day 14, dose 2

2021-05-02

Symptoms: Very weak, tied, aching joints and nausea.

Release 8 — day 21, dose 2

2021-05-07

Symptoms: Heart palpitations. I have been having intermittent Afib. It normally lasted for between half hour and three hours. Cases weakness and headaches.

Release 8 — day 28, dose 2

2021-05-14

Symptoms: Very tied and Im still getting erratic heart palpitations from time to time.Didnt really have that before the vaccination.

Release 10 — 6 months, dose 2

2021-10-18

Symptoms: So far 12 weeks of back pain and sciatica along with kidney stones. Can't sit down. In absolute agony every day.

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	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Atrial fibrillation	✓	✓	✓
SD	Back pain	·	·	✓
SD	Burning sensation	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Mobility decreased	·	·	✓
SD	Nausea	✓	✓	✓
SD	Nephrolithiasis	·	·	✓
SD	Palpitations	✓	✓	✓
SD	Sciatica	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Atrial fibrillation	✓	✓	✓
SRO	Atrioventricular block	✓	✓	○
SRO	Cardiac flutter	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Heart rate irregular	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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