4E3-24837-18470

5 vaccinations 7 coded responses 31 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 221 / VA
Registered: 2021-01-14

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
2614720 (opens in a new window)	medium	11 / 11	10	3 of 6 VAERS symptoms	same dose (5)	VA matches	2022-10-10 / 2022-12-05 / 2023-04-13 received the same day as the last call	case 507053

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

2021-01-13
Dose 1 — Moderna
2021-01-14
Registered in v-safe
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Cough — Feeling: Good

Free text: Cough, non-productive, intermittent, 2 month duration. Afebrile. No other symptoms.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-21
Dose 3 — Moderna
2022-02-11
Survey response — 12 months, dose 2
MedDRA: Rash, Rash pruritic — Feeling: Good

Free text: Rash rash scalp face neck arms legs and torso with moderate to severe itching. Duration about two weeks. Onset mid November 2021

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Dose 4 — Moderna
2022-04-27
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-02
Survey response — day 14, dose 4
MedDRA: Pruritus, Rhinorrhoea — Feeling: Good

Free text: Itching of skin of torso. Rhinorrhea

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Survey response — day 21, dose 4
MedDRA: Cough, Rhinorrhoea, Self-medication — Feeling: Good

Free text: Rhinorrhea and cough improved with high dose OTC oral antihistamine and rainstorm.

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-18
Survey response — 3 months, dose 4
MedDRA: Rash, Rash pruritic — Feeling: Fair

Free text: Rash with itching on torso

MedDRA releases: 2024-11 · check-in free text available
2022-10-10
Dose 5 — Moderna
2022-10-20
Survey response — 6 months, dose 4
MedDRA: Pruritus, Rash, Rash pruritic — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diffuse itchy skin rash on chest and abdomen has increased

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-21
Call successful
Does not wish to fill out VAERS report
2023-04-12
Survey response — 6 months, dose 5
MedDRA: COVID-19, Pyrexia, Rhinorrhoea — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-12
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-13
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-11	Moderna
3	2021-10-21	Moderna	No
4	2022-04-18	Moderna	No
5	2022-10-10	Moderna	No

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Cough, non-productive, intermittent, 2 month duration. Afebrile. No other symptoms.

Release 11 — 12 months, dose 2

2022-02-11

Symptoms: Rash rash scalp face neck arms legs and torso with moderate to severe itching. Duration about two weeks. Onset mid November 2021

Release 11 — day 14, dose 4

2022-05-02

Symptoms: Itching of skin of torso. Rhinorrhea

Release 11 — day 21, dose 4

2022-05-09

Symptoms: Rhinorrhea and cough improved with high dose OTC oral antihistamine and rainstorm.

Release 12 — 3 months, dose 4

2022-07-18

Symptoms: Rash with itching on torso

Release 12 — 6 months, dose 4

2022-10-20

Symptoms: Diffuse itchy skin rash on chest and abdomen has increased

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	Cough	✓	·	✓
SD	COVID-19	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Self-medication	·	·	✓

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