RJK-29751-17807

3 vaccinations 13 coded responses 40 check-ins 13 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 152 / PA
Registered: 2020-12-29

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
2540711 (opens in a new window)	high	8 / 11	—	0 of 6 VAERS symptoms	same dose (3)	PA matches	2021-12-21 / 2022-09-13 / 2022-12-22 received the same day as the last call	case 1233550

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
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Neck pain, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat/neck pain, believe it is unrelated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, SARS-CoV-2 test, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Irritated throat and glands · Healthcare visit (other): Covid test

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
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Diarrhea

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Dry throat — Feeling: Fair · Fatigue or tiredness

Free text: Throat/ eye dryness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
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
2021-01-26
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased, Pyrexia — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Fast heart rate with the fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 35, dose 2
MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Rash on feet, following up w dermatologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 42, dose 2
MedDRA: Chillblains — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Chilblains/pernio

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-08-01
Call 1 — Could Not Reach Participant
2021-08-03
Call 2 — Could Not Reach Participant
2021-12-21
Dose 3 — Moderna
2021-12-21
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness · Muscle or body aches, Diarrhea

Adult check-in
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Neck pain — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Pain in underarm/axillary area and neck

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Nausea

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-26
Survey response — days 1–6 daily, dose 3
MedDRA: Chillblains, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: I had chilblains on feet after 2nd vaccine, and it appears to have returned with the boost

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain — Feeling: Good · Muscle or body aches

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Health check-in — day 7, dose 3
Feeling: Fair · Headache

Adult check-in
2022-01-04
Survey response — day 14, dose 3
MedDRA: Back pain, Paraesthesia, Pre-existing disease, Tinnitus — Feeling: Good

Free text: Upper back pain, tingling sensation in vaccine arm. History of tinnitus- has become louder a week after booster.

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — day 35, dose 3
MedDRA: Chillblains, Office visit, Rash, Vaccine positive rechallenge — Feeling: Good

Free text: Chilblains rash on feet diagnosed by dermatologist after 2nd vaccine. Reoccured with booster.

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-21
Survey response — 12 months, dose 3
MedDRA: Stillbirth — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Stillborn - found to be triploidy

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-12-22
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-27	Moderna
3	2021-12-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-02	Successful 2021-01-28	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-04	Unsuccessful
2021-03-10	Unsuccessful
2022-12-21	Successful 2022-12-22	Completed over the phone

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Sore throat/neck pain, believe it is unrelated

2021-01-02

Systemic reaction (other): Irritated throat and glands

Healthcare visit (other): Covid test

2021-01-03

Systemic reaction (other): Sore throat

2021-01-04

Systemic reaction (other): Throat/ eye dryness

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Fast heart rate with the fever

Release 5 — day 35, dose 2

2021-03-04

Symptoms: Rash on feet, following up w dermatologist

Release 5 — day 42, dose 2

2021-03-10

Symptoms: Chilblains/pernio

Release 10 — days 1–6 daily, dose 3

2021-12-23

Systemic reaction (other): Pain in underarm/axillary area and neck

2021-12-26

Systemic reaction (other): I had chilblains on feet after 2nd vaccine, and it appears to have returned with the boost

2021-12-27

Systemic reaction (other): Back pain

Release 10 — day 14, dose 3

2022-01-04

Symptoms: Upper back pain, tingling sensation in vaccine arm. History of tinnitus- has become louder a week after booster.

Release 11 — day 35, dose 3

2022-01-25

Symptoms: Chilblains rash on feet diagnosed by dermatologist after 2nd vaccine. Reoccured with booster.

Release 12 — 12 months, dose 3

2022-12-21

Symptoms: Stillborn - found to be triploidy

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	SARS-CoV-2 test	✓	✓	✓
SD	Back pain	·	·	✓
SD	Chillblains	✓	✓	✓
SD	Office visit	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	✓	✓	✓
SD	Stillbirth	·	·	✓
SD	Tinnitus	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Back pain	·	·	✓
SRO	Chillblains	·	·	✓
SRO	Dry eye	✓	✓	✓
SRO	Dry throat	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Throat irritation	✓	✓	✓

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