ZWH-23747-48694

2 vaccinations 7 coded responses 17 check-ins 7 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 210 / MD
Registered: 2021-02-17

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

2021-02-17
Registered in v-safe
2021-02-17
Dose 1 — Moderna
2021-02-17
Survey response — day 0, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: Moderate chest discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — day 14, dose 1
MedDRA: Erythema — Feeling: Fair

Free text: Reddish blush of skin upper arm where shot was given. About 5 inches in diameter

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-17
Dose 2 — Moderna
2021-03-24
Survey response — day 7, dose 2
MedDRA: Malaise — Feeling: Good

Free text: On mar 17 when I got the shot I was never so sick for 3days and had all of the negative problems except for vomiting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 14, dose 2
MedDRA: Chest pain, Dizziness — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: I had chest pains and was light headed. Went to ER had slow heart rate 44 bpm. Seen my doctor since. Still have low he 47 and a little light headed. Will talk to my cardiologist on Friday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-28
Survey response — day 42, dose 2
MedDRA: Back pain, Dizziness, Musculoskeletal chest pain, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Light headed. Neck rib back pAin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-15
Survey response — 6 months, dose 2
MedDRA: Heart rate decreased, Hospitalisation — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: After my second shot I was hospitalized with a heartbeat per minute of 44

MedDRA releases: 2024-11 · check-in free text available
2021-09-15
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call 1 — Left Voicemail
2022-03-19
Survey response — 12 months, dose 2
MedDRA: Heart rate decreased, Hospitalisation — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Continue to have concerns about the vaccine that put me in the hospital with 44bpm heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-03-19
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-03-22
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-17	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-17

Systemic reaction (other): Moderate chest discomfort

Release 5 — day 14, dose 1

2021-03-03

Symptoms: Reddish blush of skin upper arm where shot was given. About 5 inches in diameter

Release 6 — day 7, dose 2

2021-03-24

Systemic reaction (other): On mar 17 when I got the shot I was never so sick for 3days and had all of the negative problems except for vomiting

Release 6 — day 14, dose 2

2021-03-31

Symptoms: I had chest pains and was light headed. Went to ER had slow heart rate 44 bpm. Seen my doctor since. Still have low he 47 and a little light headed. Will talk to my cardiologist on Friday

Release 8 — day 42, dose 2

2021-04-28

Symptoms: Light headed. Neck rib back pAin

Release 9 — 6 months, dose 2

2021-09-15

Symptoms: After my second shot I was hospitalized with a heartbeat per minute of 44

Release 11 — 12 months, dose 2

2022-03-19

Symptoms: Continue to have concerns about the vaccine that put me in the hospital with 44bpm heart rate

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	Back pain	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Heart rate decreased	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Neck pain	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Malaise	✓	✓	✓

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