4PS-17965-13791

4 vaccinations 6 coded responses 33 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 341 / FL
Registered: 2021-02-13

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
2391049 (opens in a new window)	low	11 / 11	10	5 of 10 VAERS symptoms	same dose (4)	GA differs	2022-04-25 / 2022-06-23 / 2022-07-26 received 91 days before the last call	case 883100

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

2021-02-04
Dose 1 — Moderna
2021-02-13
Registered in v-safe
2021-02-13
Survey response — day 7, dose 1
MedDRA: Erythema, Swelling — Feeling: Good · Site: Redness

Free text: I just yesterday got a small bump with pink but not painful. That was 8 days post vaccine. No other symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Headache

Free text: Tiredness but not excessive

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Dose 3 — Moderna
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Survey response — 3 months, dose 3
MedDRA: Nasopharyngitis — Feeling: Good

Free text: Slight cold for 3 weeks but not Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-25
Dose 4 — Moderna
2022-04-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-04-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-02
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-09
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-23
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-25
Survey response — 3 months, dose 4
MedDRA: Cough, Cystitis, Deafness unilateral, Headache, Laboratory test abnormal, Office visit, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: we went to Europe on a River cruise. Runny nose and sore throat 2 days before we flew home. We tested negative over there but several positive when we arrived back in (b)(6). Headache, completely deaf in rt. ear for 3 1/2 weeks, bladder inf., cough · Healthcare visit (other): PCP visit in office and later with ENT

MedDRA releases: 2024-11 · check-in free text available
2022-07-25
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-26
Call 1 — Requested Callback
2022-08-02
Call 2 — Requested Callback
2022-08-09
Call 3 — Requested Callback
2022-08-10
Callback requested for
11:00AM ET
2022-10-24
Survey response — 6 months, dose 4
MedDRA: COVID-19, Deafness, Nasopharyngitis, Office visit, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Colds increased and UTIs and hearing loss after June 2022 trip and return with Covid. · Healthcare visit (other): Office visits

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-25
Call successful
Completed over the phone
2022-10-25
Call successful
Completed over the phone
2023-04-25
Survey response — 12 months, dose 4
MedDRA: Brain fog, COVID-19, Deafness, Gait disturbance, Immunisation reaction, Laboratory test abnormal, Office visit, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-25
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-26
Call successful
Reported to VAERS during previous contact from GDIT

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-08-18	Moderna	No
4	2022-04-25	Moderna	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 4 — day 7, dose 1

2021-02-13

Systemic reaction (other): I just yesterday got a small bump with pink but not painful. That was 8 days post vaccine. No other symptoms.

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Tiredness but not excessive

Release 10 — 3 months, dose 3

2021-11-17

Symptoms: Slight cold for 3 weeks but not Covid.

Release 12 — 3 months, dose 4

2022-07-25

Symptoms: we went to Europe on a River cruise. Runny nose and sore throat 2 days before we flew home. We tested negative over there but several positive when we arrived back in (b)(6). Headache, completely deaf in rt. ear for 3 1/2 weeks, bladder inf., cough cut off by CDC

Healthcare visit (other): PCP visit in office and later with ENT

redacted (b)(6)

Release 12 — 6 months, dose 4

2022-10-24

Symptoms: Colds increased and UTIs and hearing loss after June 2022 trip and return with Covid.

Healthcare visit (other): Office visits

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	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
SD	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Cystitis	·	·	✓
SD	Deafness	·	·	✓
SD	Deafness unilateral	·	·	✓
SD	Gait disturbance	·	·	✓
SD	Headache	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Physiotherapy	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Swelling	✓	✓	✓

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