79N-23659-19116

4 vaccinations 18 coded responses 46 check-ins 17 free-text entries 5 call cases

Sex: —
Age at first dose: 41-45
ZIP prefix: 065 / CT
Registered: 2021-01-23

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

9Q3-17874-39442 Child or adolescent in my care · Female · 2022-09-17

P6V-15964-54701 Child or adolescent in my care · Female · 2022-09-17

8XV-17358-98198 Child or adolescent in my care · Female · 2022-09-17

LG3-10433-09360 Child or adolescent in my care · Male · 2022-09-17

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
2260507 (opens in a new window)	high	11 / 11	3	2 of 4 VAERS symptoms	same dose (3)	CT matches	2021-10-29 / 2021-11-17 / 2022-05-02 received the same day as the last call	case 625797

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

2021-01-22
Dose 1 — Moderna
2021-01-23
Registered in v-safe
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Lower back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Lower back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Nausea, Diarrhea

Free text: Lower back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-06
Survey response — day 14, dose 1
MedDRA: Injection site erythema — Feeling: Good

Free text: The site of injection turned red again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Psychomotor hyperactivity, Self-medication — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lower backache, some hyperactivity once I hage taken tylenol and symptoms subside a bit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Muscle or body aches

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-04
Survey response — day 42, dose 2
MedDRA: Fatigue, Gastrointestinal disorder, Pain — Feeling: Poor

Free text: Fatigue, achiness, gastrointestinal issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Pregnancy — Feeling: Good

Free text: Pregnancy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-29
Dose 3 — Moderna
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Fair · Site: Swelling, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-11-12
Survey response — day 14, dose 3
MedDRA: Lymphadenopathy, Nasopharyngitis, Oropharyngeal pain, Urticaria — Feeling: Poor

Free text: Hives all over trunk and arms, sore throat, swollen glands, cold symptoms.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Survey response — day 21, dose 3
MedDRA: Fatigue, Hypersensitivity, Polyhydramnios, Pregnancy, Pruritus, Urticaria — 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

Free text: Acute polyhydramnios @ 30 wks pregnant. Allergic type hives. Prescribed Prednisone burst. Extreme itchiness, fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 21, 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 · 1 call case(s)
2021-11-22
Call 1 — Left Voicemail
2021-11-23
Call 2 — Left Voicemail
2021-11-27
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Adenovirus test positive, Delivery, Haemophilus test positive — Feeling: Fair · Be unable to work or attend school

Free text: I just gave birth to a baby girl on (b)(6). Also tested + for adenovirus and parainfluenza virus #4.

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — 6 months, dose 3
MedDRA: Haemorrhage, Office visit, Perinatal depression, Postpartum anxiety, Vaginal haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Postpartum anxiety and depression. Irregular spotting/bleeding. · Healthcare visit (other): Dr.'s appointments with obgyn and psychiatric aprn

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-02
Call successful
Completed over the phone
2022-05-02
Call successful
Completed over the phone
2022-09-17
Dose 4 — Moderna
2022-09-17
Survey response — day 0, dose 4
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Free text: Temperature regulation

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-09-21
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-03
Survey response — day 14, dose 4
MedDRA: Pruritus, Urticaria — Feeling: Fair

Free text: Itchiness and hives randomly throughout my body.

MedDRA releases: 2024-11 · check-in free text available
2022-10-10
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-15
Survey response — day 28, dose 4
MedDRA: Pruritus, Urticaria, Vaccine positive rechallenge — Feeling: Fair

Free text: Urticaria began about 3 weeks after shot. Itchiness all over. Welts and hives when any scratching or light contact happens. This happened at about the same timeframe with my first booster in October 2021.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Survey response — day 35, dose 4
MedDRA: Arthralgia, Fatigue, Myalgia, Respiratory tract infection — Feeling: Poor · 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

Free text: Respiratory infection, achy muscles and joints, fatigue. Not covid, not flu.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Report sent to call center — day 35, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call 2 — Left Voicemail
2022-10-29
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-12-19
Survey response — 3 months, dose 4
MedDRA: Pharyngitis streptococcal — Feeling: Good · 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

Free text: Strep throat

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-20
Call 3 — Left Voicemail
2022-12-20
Call 2 — Left Voicemail
2023-03-18
Survey response — 6 months, dose 4
MedDRA: Heavy menstrual bleeding, Inflammation, Menstruation irregular — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-18
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-20
Call 1 — Left Voicemail
2023-03-20
Call 1 — Left Voicemail
2023-03-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna
3	2021-10-29	Moderna	No
4	2022-09-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-19	Successful 2022-05-02	Completed over the phone
2022-05-01	Successful 2022-05-02	Completed over the phone
2022-10-22	Unsuccessful
2022-12-19	Unsuccessful
2023-03-18	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): Lower back pain.

2021-01-25

Systemic reaction (other): Lower back pain.

2021-01-26

Systemic reaction (other): Lower back pain.

Release 3 — day 14, dose 1

2021-02-06

Symptoms: The site of injection turned red again.

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Lower backache, some hyperactivity once I hage taken tylenol and symptoms subside a bit.

Release 6 — day 42, dose 2

2021-04-04

Symptoms: Fatigue, achiness, gastrointestinal issues.

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Pregnancy

Release 10 — day 14, dose 3

2021-11-12

Symptoms: Hives all over trunk and arms, sore throat, swollen glands, cold symptoms.

Release 10 — day 21, dose 3

2021-11-19

Symptoms: Acute polyhydramnios @ 30 wks pregnant. Allergic type hives. Prescribed Prednisone burst. Extreme itchiness, fatigue.

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: I just gave birth to a baby girl on (b)(6). Also tested + for adenovirus and parainfluenza virus #4.

redacted (b)(6)

Release 11 — 6 months, dose 3

2022-05-01

Symptoms: Postpartum anxiety and depression. Irregular spotting/bleeding.

Healthcare visit (other): Dr.'s appointments with obgyn and psychiatric aprn

Release 12 — day 0, dose 4

2022-09-17

Systemic reaction (other): Temperature regulation

Release 12 — days 1–6 daily, dose 4

2022-09-21

Systemic reaction (other): Dizziness

Release 12 — day 14, dose 4

2022-10-03

Symptoms: Itchiness and hives randomly throughout my body.

Release 12 — day 28, dose 4

2022-10-15

Symptoms: Urticaria began about 3 weeks after shot. Itchiness all over. Welts and hives when any scratching or light contact happens. This happened at about the same timeframe with my first booster in October 2021.

Release 12 — day 35, dose 4

2022-10-22

Symptoms: Respiratory infection, achy muscles and joints, fatigue. Not covid, not flu.

Release 12 — 3 months, dose 4

2022-12-19

Symptoms: Strep throat

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	Office visit	·	·	✓
SD	Adenovirus test positive	·	·	✓
SD	Arthralgia	·	·	✓
SD	Delivery	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Haemophilus test positive	·	·	✓
SD	Haemorrhage	·	·	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Inflammation	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Myalgia	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Perinatal depression	·	·	✓
SD	Pharyngitis streptococcal	·	·	✓
SD	Polyhydramnios	·	·	✓
SD	Postpartum anxiety	·	·	✓
SD	Pregnancy	✓	·	✓
SD	Pruritus	·	·	✓
SD	Respiratory tract infection	·	·	✓
SD	Urticaria	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SD	Vaginal haemorrhage	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Psychomotor hyperactivity	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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