E7L-17455-34142

4 vaccinations 11 coded responses 40 check-ins 11 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 804 / CO
Registered: 2020-12-31

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
985964 (opens in a new window)	high	11 / 11	4	4 of 6 VAERS symptoms	same dose (1)	CO matches	2020-12-29 / 2021-01-29 / 2021-01-29 received the same day as the last call	case 1260804

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

2020-12-29
Dose 1 — Moderna
2020-12-31
Registered in v-safe
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Toothache — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities

Free text: Pain on back, right side of mouth, near partially erupted wisdom tooth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Medical counselling, Pain in jaw, Toothache — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches · 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: Systemic reaction (other): Yes severe tooth jaw pain on right side that started within 4-6 hours of shot in upper right arm · Healthcare visit (other): Phone call 48 hours ago and again today with my dentist re right jaw pain which is mod severe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Facial pain, Headache, Medical counselling, Neck pain, Office visit, Pain in extremity, Pain in jaw, Sleep disorder, Toothache — Feeling: Poor · Site: Pain, Swelling · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Severe pain in right lower jaw/wisdom tooth which developed within hours of my vaccine injection in my right upper arm and was associated with right neck pain, right face and jaw pain. Neck pain and face pain have resolved but jaw pain still terrible despite pain meds. Wake up at night due to jaw pain. Seeing dentist on Monday Jan 4. Now on Amox and multiple pain and anguish inflammatory meds. Headache, neck pain resolved but jaw pain still very bad. · Healthcare visit (other): Have visit with my dentist on Monday Jan 4 and have had phone contact with him several times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Medical counselling, Office visit, Pain in jaw — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Still having pain in right lower jaw · Healthcare visit (other): Visited dentist in person and phone conversation with oral surgeon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-06
Survey response — day 7, dose 1
MedDRA: Office visit, Pain in jaw — Feeling: Good · Site: Pain, Redness, Swelling · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Right jaw pain moderate....saw dentist due to pain and peridontist · Healthcare visit (other): Saw dentist and then another visit to periodontist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-25
Call 1 — Left Voicemail
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-29
Call successful
Completed over the phone
2021-01-29
Call successful
Completed over the phone
2021-01-29
Call successful
Completed over the phone
2021-01-29
Call successful
Completed over the phone
2021-01-29
Call successful
Completed over the phone
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Injection site pain, Injection site reaction — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Free text: Pain and muscle aches only at shoulder near injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain — Feeling: Good · Site: Pain · Joint pains

Free text: Left Shoulder joint pain when lifting arm (got injection there)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Survey response — day 28, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Still experiencing left shoulder pain after second Moderna vaccine which was given in left arm. Feels like a bursitis with inability to raise arm without significant pain. I think it may be slowly getting better, but still with 3/10 pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-27
Health check-in — 6 months, dose 2
Feeling: Good

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

Adult check-in
2022-01-28
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2022-01-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-30
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Good

Free text: I received my booster dose Oct 31, 2021

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Good

Free text: Didn't get any vaccine recently!!!

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-02-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-12
Dose 4 — Moderna
2022-04-29
Health check-in — 3 months, dose 3
Feeling: Good

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

Adult check-in
2022-10-11
Survey response — 6 months, dose 4
MedDRA: Dyspnoea, Electrocardiogram ambulatory abnormal, Emergency care, Extrasystoles, Palpitations, Ventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Received 5th Covid shot and flu shot on Sept 13, 2022. Developed shortness of breath and heart palpitations on Monday Sept 19, 2022. Seen in (b)(6), Colorado Emergency room. dx PVC's. Cardiac work up underway. Holter monitor shows ectopic beats.

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-10-12
Call successful
Participant prefers to complete VAERS report online
2023-04-12
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2022-01-28	Moderna	No
4	2022-04-12	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2020-12-31	Successful 2021-01-29	Completed over the phone
2021-01-01	Successful 2021-01-29	Completed over the phone
2021-01-02	Successful 2021-01-29	Completed over the phone
2021-01-04	Successful 2021-01-29	Completed over the phone
2021-01-06	Successful 2021-01-29	Completed over the phone
2022-10-11	Successful 2022-10-12	Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Pain on back, right side of mouth, near partially erupted wisdom tooth

2021-01-01

Systemic reaction (other): Yes severe tooth jaw pain on right side that started within 4-6 hours of shot in upper right arm

Healthcare visit (other): Phone call 48 hours ago and again today with my dentist re right jaw pain which is mod severe

2021-01-02

Systemic reaction (other): Severe pain in right lower jaw/wisdom tooth which developed within hours of my vaccine injection in my right upper arm and was associated with right neck pain, right face and jaw pain. Neck pain and face pain have resolved but jaw pain still terrible despite pain meds. Wake up at night due to jaw pain. Seeing dentist on Monday Jan 4. Now on Amox and multiple pain and anguish inflammatory meds. Headache, neck pain resolved but jaw pain still very bad.

Healthcare visit (other): Have visit with my dentist on Monday Jan 4 and have had phone contact with him several times

2021-01-04

Systemic reaction (other): Still having pain in right lower jaw

Healthcare visit (other): Visited dentist in person and phone conversation with oral surgeon

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Right jaw pain moderate....saw dentist due to pain and peridontist

Healthcare visit (other): Saw dentist and then another visit to periodontist

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Pain and muscle aches only at shoulder near injection site

2021-01-31

Systemic reaction (other): Left Shoulder joint pain when lifting arm (got injection there)

Release 4 — day 28, dose 2

2021-02-23

Symptoms: Still experiencing left shoulder pain after second Moderna vaccine which was given in left arm. Feels like a bursitis with inability to raise arm without significant pain. I think it may be slowly getting better, but still with 3/10 pain.

Release 11 — days 1–6 daily, dose 3

2022-01-30

Systemic reaction (other): I received my booster dose Oct 31, 2021

2022-01-31

Systemic reaction (other): Didn't get any vaccine recently!!!

Release 12 — 6 months, dose 4

2022-10-11

Symptoms: Received 5th Covid shot and flu shot on Sept 13, 2022. Developed shortness of breath and heart palpitations on Monday Sept 19, 2022. Seen in (b)(6), Colorado Emergency room. dx PVC's. Cardiac work up underway. Holter monitor shows ectopic beats.

redacted (b)(6)

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pain in jaw	✓	✓	✓
HCVO	Specialist consultation	○	○	○
HCVO	Telemedicine	○	○	○
SD	Arthralgia	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Electrocardiogram ambulatory abnormal	·	·	✓
SD	Emergency care	·	·	✓
SD	Extrasystoles	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Ventricular extrasystoles	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Facial pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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