4TM-18392-96949

2 vaccinations 13 coded responses 14 check-ins 13 free-text entries 9 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 925 / CA
Registered: 2021-04-29

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1545626 (opens in a new window)	high	10 / 11	1	9 of 29 VAERS symptoms	same dose (2)	CA matches	2021-04-28 / 2021-04-28 / 2021-08-11 received 98 days after the last call	case 642172

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

2021-03-31
Dose 1 — Moderna
2021-04-28
Dose 2 — Moderna
2021-04-29
Registered in v-safe
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Cough, Emergency care, Eye irritation, Feeding disorder, Mobility decreased, Swollen tongue, Throat tightness — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting, 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, Emergency room or emergency department visit

Free text: Systemic reaction (other): the first dose I had a dry cough 2 dose server dry cough, my tongue was swollen my throat closed up I has severe burning in my eyes chest and my back and at my at my site I coughed so hard that I needed oxygen I had to use my EpiPenI was rushed to the hospital I could not eat drink or take meds by mouth this is still in my system which I hope that if my medication is not in the system it will start all over I need help what can you do to help with the situation · Healthcare visit (other): I was rushed to the hospital by paramedics and fire department

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
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)
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · 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: Still having allergic reaction yet better than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
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)
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Balance disorder, Chest pain, Cough, Respiratory tract oedema, Rest regimen, Swollen tongue, Taste disorder — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: pain in chest and back.some coughing.air way and tongue swelling. no no taste buds working right..im pretty much confined to beds rest. now im a fall risk.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dysphonia, Pharyngeal swelling, Swollen tongue — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: I now am having side effects to the shot.still having bad dry cough swelling of my tongue & throat I can only speak in a wisper voice.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Pharyngeal swelling, Swollen tongue — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · 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: My Tongue and throat continue to swell

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
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)
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Hypersensitivity, Lethargy — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, 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: I have small red hives on my chest and back.. Im still having allergic reactions,I am pretty much lethargic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
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)
2021-05-05
Survey response — day 7, dose 2
MedDRA: Malaise, Swollen tongue — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, 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: My tongue keep swelling so much that it hurts, I feel very sick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 7, 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)
2021-05-12
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Asthenia, Migraine, Pruritus, Swollen tongue, Tongue oedema, Vaginal infection — Feeling: Poor · Be unable to work

Free text: Itchy all over my body.. still getting swollen tongue. Now stomach cramping vaginitis weak migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 21, dose 2
MedDRA: Blood glucose increased — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Glucose levels are higher

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-29
Survey response — day 28, dose 2
MedDRA: Blood glucose increased, Hypertension — Feeling: Fair · 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: High glucose and high blood pressure..still having Alergy reaction to the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Report sent to call center — day 28, 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)
2021-06-02
Survey response — day 35, dose 2
MedDRA: Chills — 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: Chills ,I have outfits coming in for you.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-09
Survey response — day 42, dose 2
MedDRA: Injection site inflammation, Injection site warmth — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Inflammation and redness warm to the touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Report sent to call center — day 42, 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)
2021-07-28
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity, Infection, Inflammation, Pruritus — Feeling: Fair · Be unable to work or attend school

Free text: Hi allergy reaction .inflammation through my body. infection and extremely itchy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-11
Call successful
Completed over the phone
2021-10-27
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Moderna
2	2021-04-28	Moderna

Call center

9 call center cases

8 successful · 1 unsuccessful

VAERS report filed, before or during a call: 9

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): the first dose I had a dry cough 2 dose server dry cough, my tongue was swollen my throat closed up I has severe burning in my eyes chest and my back and at my at my site I coughed so hard that I needed oxygen I had to use my EpiPenI was rushed to the hospital I could not eat drink or take meds by mouth this is still in my system which I hope that if my medication is not in the system it will start all over I need help what can you do to help with the situation

Healthcare visit (other): I was rushed to the hospital by paramedics and fire department

2021-04-30

Systemic reaction (other): Still having allergic reaction yet better than yesterday

2021-05-01

Systemic reaction (other): pain in chest and back.some coughing.air way and tongue swelling. no no taste buds working right..im pretty much confined to beds rest. now im a fall risk.

2021-05-02

Systemic reaction (other): I now am having side effects to the shot.still having bad dry cough swelling of my tongue & throat I can only speak in a wisper voice.

2021-05-03

Systemic reaction (other): My Tongue and throat continue to swell

2021-05-04

Systemic reaction (other): I have small red hives on my chest and back.. Im still having allergic reactions,I am pretty much lethargic

Release 8 — day 7, dose 2

2021-05-05

Systemic reaction (other): My tongue keep swelling so much that it hurts, I feel very sick.

Release 8 — day 14, dose 2

2021-05-12

Symptoms: Itchy all over my body.. still getting swollen tongue. Now stomach cramping vaginitis weak migraine

Release 8 — day 21, dose 2

2021-05-21

Symptoms: Glucose levels are higher

Release 8 — day 28, dose 2

2021-05-29

Symptoms: High glucose and high blood pressure..still having Alergy reaction to the injection

Release 8 — day 35, dose 2

2021-06-02

Symptoms: Chills ,I have outfits coming in for you.

Release 9 — day 42, dose 2

2021-06-09

Symptoms: Inflammation and redness warm to the touch

Release 9 — 3 months, dose 2

2021-07-28

Symptoms: Hi allergy reaction .inflammation through my body. infection and extremely itchy

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	Emergency care	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Asthenia	✓	·	✓
SD	Blood glucose increased	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Hypersensitivity	✓	·	✓
SD	Hypertension	✓	✓	✓
SD	Infection	✓	·	✓
SD	Inflammation	✓	·	✓
SD	Injection site inflammation	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Swollen tongue	✓	·	✓
SD	Tongue oedema	○	✓	○
SD	Vaginal infection	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dysphonia	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Feeding disorder	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Pharyngeal swelling	✓	✓	✓
SRO	Respiratory tract oedema	✓	✓	✓
SRO	Rest regimen	✓	✓	✓
SRO	Swollen tongue	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Throat tightness	✓	✓	✓

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