69M-16663-52066

5 vaccinations 10 coded responses 41 check-ins 10 free-text entries 7 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 207 / MD
Registered: 2021-03-15

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
2019693 (opens in a new window)	high	9 / 11	1	1 of 5 VAERS symptoms	same dose (2)	MD matches	2021-04-10 / 2021-04-12 / 2022-01-09 received the same day as the last call	case 1079249

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

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Moderna
2021-03-15
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Blister — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Atypical blood pressure of 100/80. (Typically 130/80.) Large, non-painfull water blister on my back with a diameter of 1 to 2 cm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Blister, Syncope — Feeling: Good

Free text: 4 cm water blister on my back. Yesterday, I came close to fainting four times.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Blister — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: 6 cm water blister on my back - no obvious cause for it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Blister — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Water blister on my back measured to be 1.25 x 0.75 inches. Identified by my doctor as a probable vaccie side effect.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Survey response — day 7, dose 2
MedDRA: Blister — Feeling: Good

Free text: Large water blister on my back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Survey response — day 35, dose 2
MedDRA: Nausea, Pre-existing disease, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Nausea, vomiting due to diverticulitis. Probably not vaccine related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — day 35, 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)
2021-05-22
Survey response — day 42, dose 2
MedDRA: Nausea, Vomiting — 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, Emergency room or emergency department visit

Free text: Abdominal, nausea, vomiting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
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)
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Abdominal pain, Nausea — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Abdominal pain nausea vomi3

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-14
Call 1 — Left Voicemail
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Muscle strain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Strained knee

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2021-11-29
Dose 3 — Moderna
2022-01-09
Call successful
Completed over the phone
2022-03-15
Dose 4 — Moderna
2022-04-12
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-05-01
Survey response — day 42, dose 4
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-18
Dose 5 — Moderna
Co-administered: Flu
2022-09-18
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-23
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-25
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-09
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-16
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-18
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-19
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-10	Moderna
3	2021-11-29	Moderna	No
4	2022-03-15	Moderna	No
5	2022-09-18	Moderna	Flu

Call center

7 call center cases

7 successful

VAERS report filed, before or during a call: 7

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Atypical blood pressure of 100/80. (Typically 130/80.) Large, non-painfull water blister on my back with a diameter of 1 to 2 cm.

2021-04-14

Systemic reaction (other): 4 cm water blister on my back. Yesterday, I came close to fainting four times.

2021-04-15

Systemic reaction (other): 6 cm water blister on my back - no obvious cause for it

2021-04-16

Systemic reaction (other): Water blister on my back measured to be 1.25 x 0.75 inches. Identified by my doctor as a probable vaccie side effect.

Release 7 — day 7, dose 2

2021-04-17

Systemic reaction (other): Large water blister on my back

Release 8 — day 35, dose 2

2021-05-15

Symptoms: Nausea, vomiting due to diverticulitis. Probably not vaccine related.

Release 8 — day 42, dose 2

2021-05-22

Symptoms: Abdominal, nausea, vomiting

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Abdominal pain nausea vomi3

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: Strained knee

Release 11 — day 42, dose 4

2022-05-01

Symptoms: Diarrhea

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	Diarrhoea	·	·	✓
SD	Muscle strain	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Blister	✓	✓	✓
SRO	Syncope	✓	✓	✓

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