2FN-86791-88253

3 vaccinations 15 coded responses 29 check-ins 15 free-text entries 14 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 936 / CA
Registered: 2021-01-15

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
1910048 (opens in a new window)	medium	10 / 11	9	6 of 13 VAERS symptoms	same dose (3)	CA matches	2021-11-12 / 2021-11-12 / 2021-11-30 received 12 days after the last call	case 1178477

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

2021-01-14
Dose 1 — Moderna
2021-01-15
Registered in v-safe
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-02-12
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain, Eye swelling — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Eyes swollen pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Insomnia — Feeling: Poor · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Anxiety back pn meficcation no sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Asthenia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Anxirtjy weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Balance disorder, Headache — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Aneixity headacm lost of balance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-03-04
Survey response — day 21, dose 2
MedDRA: Insomnia, Office visit, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain cannot sleep · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — day 28, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Hesdack yifrneds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Asthenia, Chest pain, Decreased appetite, Dyspnoea, Fatigue, Oxygen saturation decreased, Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Extreme fatigue, shortness of breath, low O2 stats, weakness, chest pain loss of appetite, not socializing in person or on phone due to fatigue. · Healthcare visit (other): I was too weak to travel to my doctor's office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Call 1 — Left Voicemail
2021-08-18
Survey response — 6 months, dose 2
MedDRA: Angina pectoris, Gait inability, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Heart pain unable to walk · Healthcare visit (other): Home visit

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
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)
2021-08-20
Call 1 — Left Voicemail
2021-11-12
Dose 3 — Moderna
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Dysstasia — Feeling: Poor · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Still having difficulty standing up still have to have assistance we never had this problem before I have the bracelet. Before

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Adult check-in
2021-11-18
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-18
Call 1 — Left Voicemail
2021-11-19
Survey response — day 7, dose 3
MedDRA: Gait inability, Office visit — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): And up for a couple of days just now beginning to be honest and up still can't walk · Healthcare visit (other): Saw my doctor

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 7, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-24
Call 1 — Requested Callback
2021-11-27
Survey response — day 14, dose 3
MedDRA: Asthenia, Fatigue, Gait disturbance — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Was very weak yesterday a difficulty walking I didn't call to um standing for a Time very tired

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Call 2 — Requested Callback
2021-11-30
Callback requested for
06:00PM ET
2021-11-30
Call successful
Completed over the phone
2021-12-03
Survey response — day 21, dose 3
MedDRA: Asthenia, Gait disturbance, Headache, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Ability to walk is a problem I have a headaches might I have some memory loss when I get weak and still

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-13
Survey response — day 28, dose 3
MedDRA: Asthenia, Balance disorder, Gait disturbance, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Weakness difficulty walking weakness difficulty walking maintaining my balance Sartorius stomach

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-14
Call 1 — Left Voicemail
2021-12-20
Survey response — day 35, dose 3
MedDRA: Chest pain, Confusional state, Fatigue, Insomnia, Muscular weakness, Office visit, Pain in extremity — Feeling: Poor · 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: Symptoms: Weakness in legs severe chest pains some confusion tiredness unable to sleep the pain is on the right side of the chest and arm and hand as well as in the middle of my chest and down my left arm so it's officially over both arms in my chest my legs a · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Report sent to call center — day 35, dose 3
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)
2021-12-23
Call successful
Reported to VAERS during previous contact from GDIT
2021-12-26
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-11
Survey response — 3 months, dose 3
MedDRA: Dysstasia, Fatigue, Medical counselling, Pain, Restlessness, Vomiting — Feeling: Poor · 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: Symptoms: Pain unable to stand up on my own to have assistants getti fatigue vomiting restlessness · Healthcare visit (other): Came to my residence give me treatment and shots all of

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — 3 months, dose 3
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)
2022-02-21
Call 1 — Left Voicemail
2022-05-16
Health check-in — 6 months, dose 3
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-11-12	Moderna	No

Call center

14 call center cases

6 successful · 8 unsuccessful

VAERS report filed, before or during a call: 6

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Eyes swollen pain

2021-02-15

Systemic reaction (other): Anxiety back pn meficcation no sleep

2021-02-16

Systemic reaction (other): Anxirtjy weakness

2021-02-17

Systemic reaction (other): Aneixity headacm lost of balance

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Pain cannot sleep

Healthcare visit (other): Office visit

Release 5 — day 28, dose 2

2021-03-11

Symptoms: Hesdack yifrneds

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Extreme fatigue, shortness of breath, low O2 stats, weakness, chest pain loss of appetite, not socializing in person or on phone due to fatigue.

Healthcare visit (other): I was too weak to travel to my doctor's office

Release 9 — 6 months, dose 2

2021-08-18

Symptoms: Heart pain unable to walk

Healthcare visit (other): Home visit

Release 10 — days 1–6 daily, dose 3

2021-11-16

Systemic reaction (other): Still having difficulty standing up still have to have assistance we never had this problem before I have the bracelet. Before

Release 10 — day 7, dose 3

2021-11-19

Systemic reaction (other): And up for a couple of days just now beginning to be honest and up still can't walk

Healthcare visit (other): Saw my doctor

Release 10 — day 14, dose 3

2021-11-27

Symptoms: Was very weak yesterday a difficulty walking I didn't call to um standing for a Time very tired

Release 10 — day 21, dose 3

2021-12-03

Symptoms: Ability to walk is a problem I have a headaches might I have some memory loss when I get weak and still

Release 10 — day 28, dose 3

2021-12-13

Symptoms: Weakness difficulty walking weakness difficulty walking maintaining my balance Sartorius stomach

Release 10 — day 35, dose 3

2021-12-20

Symptoms: Weakness in legs severe chest pains some confusion tiredness unable to sleep the pain is on the right side of the chest and arm and hand as well as in the middle of my chest and down my left arm so it's officially over both arms in my chest my legs a cut off by CDC

Healthcare visit (other): Office visit

Release 11 — 3 months, dose 3

2022-02-11

Symptoms: Pain unable to stand up on my own to have assistants getti fatigue vomiting restlessness

Healthcare visit (other): Came to my residence give me treatment and shots all of

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	Medical counselling	✓	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Angina pectoris	✓	·	✓
SD	Asthenia	✓	✓	✓
SD	Balance disorder	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Confusional state	·	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Dysstasia	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gait disturbance	·	·	✓
SD	Gait inability	✓	·	✓
SD	Headache	·	·	✓
SD	Insomnia	✓	✓	✓
SD	Muscular weakness	·	·	✓
SD	Oxygen saturation decreased	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Restlessness	·	·	✓
SD	Unevaluable event	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Dysstasia	·	·	✓
SRO	Eye pain	✓	✓	✓
SRO	Eye swelling	✓	✓	✓
SRO	Gait inability	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	✓	✓	✓

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