5TV-10139-63486

4 vaccinations 5 coded responses 27 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 956 / CA
Registered: 2020-12-23

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
2396409 (opens in a new window)	high	11 / 11	—	5 of 6 VAERS symptoms	same dose (4)	CA matches	2022-04-27 / 2022-07-13 / 2022-07-29 received the same day as the last call	case 892115

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2020-12-24
Survey response — days 1–6 daily, dose 1
MedDRA: Head injury, Headache — Feeling: Good · Site: Pain · Headache

Free text: headache but NOT caused by shot, hit my head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-13
Survey response — day 21, dose 1
MedDRA: Injection site pain, Rhinorrhoea — Feeling: Good

Free text: runny nose but think it is mostly due to constant mask wearing. otherwise feel great. arm still a bit sore at injection site but bearable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Dose 2 — Moderna
2021-01-27
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

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

Adult check-in
2021-02-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-04-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2022-01-20
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-27
Dose 4 — Moderna
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Respiratory syncytial virus infection — Feeling: Fair · 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: Was diagnosed with RSV virus in April

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 6 months, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-25
Survey response — day 28, dose 4
MedDRA: Fatigue, Pain — Feeling: Good

Free text: Aches and pains, General fatigue, but it all has to do with being in the altitude and sleeping in an unusual bed.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-28
Survey response — 3 months, dose 4
MedDRA: Diarrhoea, Headache, Nausea, Oropharyngeal pain, Pain, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Sore throat, nausea, diahreae? Aches, headache · Healthcare visit (other): Had to be swabbed to ensure clear

MedDRA releases: 2024-11 · check-in free text available
2022-07-28
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-29
Call successful
Completed over the phone
2023-04-27
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-20	Moderna
3	2021-10-28	Moderna	No
4	2022-04-27	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 1 — days 1–6 daily, dose 1

2020-12-24

Systemic reaction (other): headache but NOT caused by shot, hit my head

Release 1 — day 21, dose 1

2021-01-13

Symptoms: runny nose but think it is mostly due to constant mask wearing. otherwise feel great. arm still a bit sore at injection site but bearable

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: Was diagnosed with RSV virus in April

Release 11 — day 28, dose 4

2022-05-25

Symptoms: Aches and pains, General fatigue, but it all has to do with being in the altitude and sleeping in an unusual bed.

Release 12 — 3 months, dose 4

2022-07-28

Symptoms: Sore throat, nausea, diahreae? Aches, headache

Healthcare visit (other): Had to be swabbed to ensure clear

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	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Head injury	✓	✓	✓
SRO	Headache	✓	✓	✓

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