4FG-13791-05722

4 vaccinations 6 coded responses 34 check-ins 6 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 115 / NY
Registered: 2021-01-18

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
2341857 (opens in a new window)	high	10 / 11	2	3 of 7 VAERS symptoms	same dose (4)	NY matches	2022-06-21 / 2022-06-22 / 2022-06-29 received the same day as the last call	case 811555

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

2021-01-17
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Soreness at injection sight

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Infection, Influenza, Pain, Pyrexia — Feeling: Good · Site: Pain, Swelling

Free text: It is now 5 days after my injection and you did not ask about symptoms on timely basis. I had fever, aches , infections soreness and flu symptoms beginning on early morning after injection date and for 3 days thereafter- just like last time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Influenza like illness — Feeling: Good · Be unable to do your normal daily activities

Free text: Flu symptoms for 3 days after injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Dose 3 — Moderna
2021-10-30
Survey response — day 7, dose 3
MedDRA: Respiratory disorder — 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 · Outpatient clinic or urgent care clinic visit

Free text: Upper respiratory issues

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Report sent to call center — day 7, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-02
Call successful
Does not wish to fill out VAERS report
2021-11-04
Health check-in — day 14, dose 3
Feeling: Poor

Adult check-in
2021-11-11
Health check-in — day 21, dose 3
Feeling: Poor

Adult check-in
2021-11-18
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-25
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-02
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-21
Dose 4 — Moderna
2022-06-28
Survey response — day 7, dose 4
MedDRA: Cough, Loss of consciousness, Medical counselling, Reaction to previous exposure to any vaccine, Respiratory disorder — 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: Systemic reaction (other): Severe respiratory issues and cough identical to my condition after shot 3 when it persisted for many many weeks. Passed out from respiratory and cough issues · Healthcare visit (other): Phone call

MedDRA releases: 2024-11 · check-in free text available
2022-06-28
Report sent to call center — day 7, 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)
2022-06-29
Call 1 — Could Not Reach Participant
2022-06-29
Call 1 — Could Not Reach Participant
2022-06-29
Call successful
Completed over the phone
2022-07-05
Survey response — day 14, dose 4
MedDRA: Hospitalisation, Respiratory disorder, Vaccine positive rechallenge — 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 · Emergency room or emergency department visit, Hospitalization

Free text: I was hospitalized for two days resulting from respiratory side effects from vaccine identical in timing and character to my symptoms after the 3 rd shot

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Report sent to call center — day 14, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-07-06
Call 2 — Left Voicemail
2022-07-06
Call 2 — Could Not Reach Participant
2022-07-06
Call 1 — Could Not Reach Participant
2022-07-06
Call successful
Completed over the phone
2022-07-12
Health check-in — day 21, dose 4
Feeling: Poor

Adult check-in
2022-07-19
Health check-in — day 28, dose 4
Feeling: Poor

Adult check-in
2022-07-26
Health check-in — day 35, dose 4
Feeling: Poor

Adult check-in
2022-08-02
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-09-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-16	Moderna
3	2021-10-21	Moderna	No
4	2022-06-21	Moderna	No

Call center

4 call center cases

3 successful · 1 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 2

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Soreness at injection sight

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): It is now 5 days after my injection and you did not ask about symptoms on timely basis. I had fever, aches , infections soreness and flu symptoms beginning on early morning after injection date and for 3 days thereafter- just like last time

2021-02-22

Systemic reaction (other): Flu symptoms for 3 days after injection

Release 10 — day 7, dose 3

2021-10-30

Systemic reaction (other): Upper respiratory issues

Release 12 — day 7, dose 4

2022-06-28

Systemic reaction (other): Severe respiratory issues and cough identical to my condition after shot 3 when it persisted for many many weeks. Passed out from respiratory and cough issues

Healthcare visit (other): Phone call

Release 12 — day 14, dose 4

2022-07-05

Symptoms: I was hospitalized for two days resulting from respiratory side effects from vaccine identical in timing and character to my symptoms after the 3 rd shot

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	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Cough	·	·	✓
SRO	Infection	✓	✓	✓
SRO	Influenza	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Loss of consciousness	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Respiratory disorder	·	·	✓

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