5A4-22252-05894

5 vaccinations 11 coded responses 44 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 917 / CA
Registered: 2021-02-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Registered dependents

4WA-19923-56606 Adult relative or friend · Male · 2022-11-25

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
2566804 (opens in a new window)	high	10 / 11	2	2 of 5 VAERS symptoms	same dose (5)	CA matches	2022-10-21 / 2022-10-23 / 2023-01-24 received the same day as the last call	case 91107

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms — Feeling: Good · Muscle or body aches

Free text: Muscle on thigh and feet felt like they were going to cramp last night ate mustard and this morning was gone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspepsia, Headache — Feeling: Good · Headache

Free text: Acid indigestion and the headache is just on the temple off anon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: Off and on headache at the Temple left side not as often today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 35, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities

Free text: Circulation on my legs especially the left got test for blood clot waiting for results in three days but said they said it didnt look like a blood clot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-07
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-09-13
Dose 3 — Moderna
Co-administered: Tetanus
2021-10-25
Survey response — day 42, dose 3
MedDRA: Cardiospasm, Myocardial infarction, Nasopharyngitis, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: April 22 2021 had heart attack and on Oct 14 2021 had a heart spasm From the cold · Healthcare visit (other): Thought having another Heart attack

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-08
Call 1 — Could Not Reach Participant
2021-11-11
Call 2 — Left Voicemail
2021-12-13
Survey response — 3 months, dose 3
MedDRA: Angina pectoris, Arterial stiffness, Myocardial infarction, Nasopharyngitis, Vaccine positive rechallenge — Feeling: Fair · 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: When get cold my vines get stiff and make my heart hurt my son said my heart attack in April was a couple of weeks after vaccine now this time it was after boaster

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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-12-14
Call successful
Does not wish to fill out VAERS report
2022-05-04
Dose 4 — Moderna
2022-05-14
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-25
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-06-01
Survey response — day 28, dose 4
MedDRA: Nasopharyngitis, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Body Aches and bad cold

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-04
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Dose 5 — Moderna
2022-11-02
Survey response — day 7, dose 5
MedDRA: Oedema peripheral, Pain in extremity, Tenderness — Feeling: Good

Free text: Only after my last booster shot arm was sore and under arm was swollen for a week and half and hurt to touch

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — 6 months, dose 4
MedDRA: Immediate post-injection reaction, Oedema peripheral, Pain in extremity — Feeling: Good

Free text: Right after my last booster on October 21 my arm was sore and underneath my under arm got swollen it lasted for about a little over a week and it finally went away

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-18
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-02
Survey response — day 42, dose 5
MedDRA: Angina pectoris, Bone pain, Myalgia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Bones hurt when it's cold and my heart hurts when it's cold never had my heart hurt before until after my booster shot and my muscles hurt

MedDRA releases: 2024-11 · check-in free text available
2023-01-21
Survey response — 3 months, dose 5
MedDRA: Angina pectoris, Arthralgia, Pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-21
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-24
Call successful
Does not wish to fill out VAERS report
2023-01-24
Call successful
Completed over the phone
2023-04-21
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-09	Moderna
3	2021-09-13	Moderna	Tetanus
4	2022-05-04	Moderna	No
5	2022-10-21	Moderna	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): Muscle on thigh and feet felt like they were going to cramp last night ate mustard and this morning was gone

2021-02-07

Systemic reaction (other): Acid indigestion and the headache is just on the temple off anon

2021-02-08

Systemic reaction (other): Off and on headache at the Temple left side not as often today

Release 7 — day 35, dose 2

2021-04-14

Symptoms: Circulation on my legs especially the left got test for blood clot waiting for results in three days but said they said it didnt look like a blood clot

Release 10 — day 42, dose 3

2021-10-25

Symptoms: April 22 2021 had heart attack and on Oct 14 2021 had a heart spasm From the cold

Healthcare visit (other): Thought having another Heart attack

Release 10 — 3 months, dose 3

2021-12-13

Symptoms: When get cold my vines get stiff and make my heart hurt my son said my heart attack in April was a couple of weeks after vaccine now this time it was after boaster

Release 11 — day 28, dose 4

2022-06-01

Symptoms: Body Aches and bad cold

Release 12 — 6 months, dose 4

2022-11-02

Symptoms: Right after my last booster on October 21 my arm was sore and underneath my under arm got swollen it lasted for about a little over a week and it finally went away

Release 12 — day 7, dose 5

2022-11-02

Systemic reaction (other): Only after my last booster shot arm was sore and under arm was swollen for a week and half and hurt to touch

Release 12 — day 42, dose 5

2022-12-02

Symptoms: Bones hurt when it's cold and my heart hurts when it's cold never had my heart hurt before until after my booster shot and my muscles hurt

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	Unevaluable event	·	·	✓
SD	Angina pectoris	·	·	✓
SD	Arterial stiffness	·	·	✓
SD	Arthralgia	·	·	✓
SD	Bone pain	·	·	✓
SD	Cardiospasm	·	·	✓
SD	Immediate post-injection reaction	·	·	✓
SD	Myalgia	·	·	✓
SD	Myocardial infarction	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oedema peripheral	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Unevaluable event	✓	✓	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Tenderness	·	·	✓

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