5US-28461-13695

4 vaccinations 12 coded responses 31 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 190 / PA
Registered: 2021-04-17

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
2615240 (opens in a new window)	high	10 / 11	6	3 of 12 VAERS symptoms	same dose (4)	PA matches	2022-04-12 / 2022-10-24 / 2023-04-14 received the same day as the last call	case 507400

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

2021-03-11
Dose 1 — Moderna
2021-04-15
Dose 2 — Moderna
2021-04-17
Registered in v-safe
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Feeling abnormal — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Weakness & fogginess

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Burning sensation — Feeling: Fair · Site: Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Yesterday, burning sensation in my extremities & joints.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · Nausea, Vomiting, Abdominal pain

Adult check-in
2021-04-29
Survey response — day 14, dose 2
MedDRA: Axillary pain, Breast pain, Pain in extremity, Pruritus — Feeling: Good

Free text: Itching & pain on the vaccinated side arm, underarm & breast. Lasted 2 days, now gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Survey response — day 28, dose 2
MedDRA: Injection site haemorrhage, Injection site pain — Feeling: Good

Free text: Large Unexplained Ecchymosis at the first vaccine site. Slightly sore to touch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — day 35, dose 2
MedDRA: Abdominal pain, Diarrhoea, Gastrointestinal disorder, Nausea — Feeling: Fair

Free text: Severe gi symptoms: nausea, abdominal pain & diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 42, dose 2
MedDRA: Cough, Headache, Hyperhidrosis, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat, cough, headache & sweating fir 2days. Grandson had same symptoms & tested Covid negative x3.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-09
Survey response — day 14, dose 3
MedDRA: Cough, Fatigue, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, Sneezing, Throat irritation — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore scratchy throat, nasal congestion, sneeze, cough, fatigue, runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — day 21, dose 3
MedDRA: Abdominal pain, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Abdominal pain & vomiting

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Epistaxis, Fatigue, Rhinorrhoea — Feeling: Fair

Free text: Runny nose, nosebleed fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Dose 4 — Moderna
2022-04-18
Survey response — days 1–6 daily, dose 4
MedDRA: Irritability — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Irritability

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-03
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-25
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-12
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-12
Survey response — 12 months, dose 4
MedDRA: COVID-19, Dyspnoea — 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

MedDRA releases: 2024-11
2023-04-12
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-04-13
Call 1 — Requested Callback
2023-04-14
Callback requested for
2023-04-14
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-15	Moderna
3	2021-10-25	Moderna	No
4	2022-04-12	Moderna	No

Call center

1 call center case

1 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Weakness & fogginess

2021-04-19

Systemic reaction (other): Yesterday, burning sensation in my extremities & joints.

2021-04-20

Systemic reaction (other): Irritability

Release 8 — day 14, dose 2

2021-04-29

Symptoms: Itching & pain on the vaccinated side arm, underarm & breast. Lasted 2 days, now gone.

Release 8 — day 28, dose 2

2021-05-13

Symptoms: Large Unexplained Ecchymosis at the first vaccine site. Slightly sore to touch.

Release 8 — day 35, dose 2

2021-05-20

Symptoms: Severe gi symptoms: nausea, abdominal pain & diarrhea

Release 8 — day 42, dose 2

2021-05-27

Symptoms: Sore throat, cough, headache & sweating fir 2days. Grandson had same symptoms & tested Covid negative x3.

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Sore scratchy throat, nasal congestion, sneeze, cough, fatigue, runny nose

Release 10 — day 21, dose 3

2021-11-16

Symptoms: Abdominal pain & vomiting

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: Runny nose, nosebleed fatigue.

Release 11 — days 1–6 daily, dose 4

2022-04-18

Systemic reaction (other): Irritability

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
SD	Abdominal pain	✓	✓	✓
SD	Axillary pain	✓	✓	✓
SD	Breast pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Injection site haemorrhage	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Throat irritation	·	·	✓
SD	Vomiting	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Irritability	✓	✓	✓

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