XV4-31561-43108

3 vaccinations 4 coded responses 38 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 622 / IL
Registered: 2021-02-12

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
1916537 (opens in a new window)	high	9 / 11	4	1 of 6 VAERS symptoms	same dose (3)	IL matches	2021-10-29 / 2021-11-01 / 2021-12-02 received the same day as the last call	case 1191641

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Health check-in — 0 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Redness, Itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-19
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-13
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-10
Survey response — 6 month, dose 2
MedDRA: Dyspnoea exertional, Fatigue, Pre-existing disease — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — 0 day, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, 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: Good · Site: Pain · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — 28 day, dose 3
MedDRA: Abnormal sensation in eye, Eye disorder, Facial nerve disorder, Sensory disturbance, Tic, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-11-26
Report sent to call center — 28 day, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-01
Call 1 — Left Voicemail
2021-12-02
Call successful
Completed over the phone
2021-12-03
Health check-in — 35 day, dose 3
Feeling: Good

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

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

Adult check-in
2022-04-29
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-10-29
Survey response — 12 month, dose 3
MedDRA: Macular hole, Metamorphopsia, Office visit, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-10-29
Report sent to call center — 12 month, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-26	Successful 2021-12-02	Completed over the phone
2022-10-29	Unsuccessful

Free text

Release 4

Systemic reaction (other): Slight burning and aching at injection sight

Release 9

Symptoms: Fatigue, tire more easily.Shortness of breath upon exertionI had covid in August 2020 my symotoms are perhaps due to covid

Release 10

Symptoms: I am having some issues with my left facial nerve. I have a persistent tic of my left eye with an altered sensation of my forehead eye and cheek

Healthcare visit (other): Appointment with my primary physician 11/27

Release 12

Symptoms: Blurred and distorted vision: a hole in my macula

Healthcare visit (other): In office visits with retina specialist

Free-text releases are not linked to a specific 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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abnormal sensation in eye	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Eye disorder	·	·	✓
SD	Facial nerve disorder	·	·	✓
SD	Fatigue	·	·	✓
SD	Macular hole	·	·	✓
SD	Metamorphopsia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Sensory disturbance	·	·	✓
SD	Tic	·	·	✓
SD	Vision blurred	·	·	✓
SRO	Injection site pain	✓	✓	✓

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