24W-51285-90456

5 vaccinations 9 coded responses 67 check-ins 9 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 921 / CA
Registered: 2021-01-22

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

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
2195000 (opens in a new window)	high	10 / 11	1	3 of 10 VAERS symptoms	same dose (4)	CA matches	2022-03-21 / 2022-03-21 / 2022-03-23 received the same day as the last call	case 384654

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · Chills

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-20
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat and possible otitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — day 7, dose 2
MedDRA: Ear infection, Pharyngitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Otitis and pharyngitis starting yesterday. Went on Amoxicillin Clav 875-125 mg bid

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-21
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-09-10
Dose 3 — Moderna
2021-09-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-09-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-09-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-17
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-09-24
Survey response — day 14, dose 3
MedDRA: Fatigue, Sluggishness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Immense fatigue Feeling very tired mid day and again in the evening. Sluggish Going on for about a week

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-08
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-15
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-21
Dose 4 — Moderna
2022-03-21
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-03-22
Survey response — days 1–6 daily, dose 4
MedDRA: Corneal graft failure, Office visit, Paraesthesia, Vision blurred — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Intermittent paresthesias left foot · Healthcare visit (other): Outpatient ophthalmology clinic Cornea graft hazy since receipt of vaccine number 4

MedDRA releases: 2024-11 · check-in free text available
2022-03-22
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-03-23
Survey response — days 1–6 daily, dose 4
MedDRA: Office visit — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Visit with ophthalmologist

MedDRA releases: 2024-11 · check-in free text available
2022-03-23
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-03-23
Call successful
Completed over the phone
2022-03-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-03-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-03-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-03-27
Survey response — days 1–6 daily, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cloudy vision OS worse since COvID booster on 3/21/2022

MedDRA releases: 2024-11 · check-in free text available
2022-03-28
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-19
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-16
Dose 5 — Moderna
2022-10-16
Survey response — day 0, dose 5
MedDRA: Body temperature increased — Feeling: Good · Fatigue or tiredness

Free text: Fever 99.5 F

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Survey response — days 1–6 daily, dose 5
MedDRA: Dizziness — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Survey response — days 1–6 daily, dose 5
MedDRA: Cough — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Intermittent coughing

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2022-10-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-23
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-30
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-06
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-13
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-20
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-27
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-15
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-18
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-20	Moderna
3	2021-09-10	Moderna	No
4	2022-03-21	Moderna	No
5	2022-10-16	Moderna	No

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Sore throat and possible otitis

Release 4 — day 7, dose 2

2021-02-27

Systemic reaction (other): Otitis and pharyngitis starting yesterday. Went on Amoxicillin Clav 875-125 mg bid

Release 9 — day 14, dose 3

2021-09-24

Symptoms: Immense fatigue Feeling very tired mid day and again in the evening. Sluggish Going on for about a week

Release 11 — days 1–6 daily, dose 4

2022-03-22

Systemic reaction (other): Intermittent paresthesias left foot

Healthcare visit (other): Outpatient ophthalmology clinic Cornea graft hazy since receipt of vaccine number 4

2022-03-23

Healthcare visit (other): Visit with ophthalmologist

2022-03-27

Systemic reaction (other): Cloudy vision OS worse since COvID booster on 3/21/2022

Release 12 — day 0, dose 5

2022-10-16

Systemic reaction (other): Fever 99.5 F

Release 12 — days 1–6 daily, dose 5

2022-10-17

Systemic reaction (other): Dizziness

2022-10-18

Systemic reaction (other): Intermittent coughing

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	Corneal graft failure	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Vision blurred	·	·	✓
SD	Fatigue	·	·	✓
SD	Sluggishness	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Cough	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Ear infection	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Pharyngitis	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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