XX6-12959-03987

3 vaccinations 11 coded responses 33 check-ins 11 free-text entries 7 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 234 / VA
Registered: 2021-02-08

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1963181 (opens in a new window)	high	10 / 11	-3	2 of 5 VAERS symptoms	same dose (2)	VA matches	2021-03-10 / 2021-03-17 / 2021-12-20 received 193 days after the last call	case 774803

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

2021-02-08
Registered in v-safe
2021-02-08
Dose 1 — Moderna
2021-02-08
Health check-in — 0 day, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-03-01
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-10
Dose 2 — Moderna
2021-03-10
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Pain, Itching · None · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Hot flush — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — 7 day, dose 2
Feeling: Good · Nausea

Adult check-in
2021-03-24
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — 21 day, dose 2
MedDRA: Diabetic ketoacidosis, Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-07
Survey response — 28 day, dose 2
MedDRA: Diabetic ketoacidosis, Office visit — Feeling: Poor · 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-07
Report sent to call center — 28 day, 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)
2021-04-14
Survey response — 35 day, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work, 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-14
Report sent to call center — 35 day, 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)
2021-04-21
Survey response — 42 day, dose 2
MedDRA: Blindness, Diabetic ketoacidosis — Feeling: Fair · Be unable to work, 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: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-21
Report sent to call center — 42 day, 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)
2021-06-10
Survey response — 3 month, dose 2
MedDRA: Diabetic ketoacidosis, Type 2 diabetes mellitus — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-10
Report sent to call center — 3 month, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-09
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary mass — Feeling: Fair · Site: Pain, Swelling, Itching · Headache · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2021-10-28
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-30
Survey response — 7 day, dose 3
MedDRA: Blood glucose increased — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-08
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-13
Survey response — 21 day, dose 3
MedDRA: Cough, Headache, Nasopharyngitis, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-20
Survey response — 28 day, dose 3
MedDRA: Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2021-11-20
Report sent to call center — 28 day, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-27
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2021-12-20
Call successful
Does not wish to fill out VAERS report
2022-04-25
Survey response — 6 month, dose 3
MedDRA: Heavy menstrual bleeding, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-04-25
Report sent to call center — 6 month, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-26
Call 1 — Requested Callback
2022-05-02
Call 2 — Could Not Reach Participant
2022-05-03
Call 3 — Left Voicemail
2022-05-03
Callback requested for
05:15PM ET
2022-10-23
Health check-in — 12 month, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-10	Moderna
3	2021-10-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-07	Successful	Completed over the phone
2021-04-14	Successful	Completed over the phone
2021-04-21	Successful	Completed over the phone
2021-06-10	Successful	Completed over the phone
2021-10-28	Successful	Does not wish to fill out VAERS report
2021-11-20	Successful 2021-12-20	Does not wish to fill out VAERS report
2022-04-25	Unsuccessful

Free text

Release 5

Systemic reaction (other): Hot flashes but consistent

Release 6

Symptoms: Diagnosis of DKA last night after having breathing issues. Not sure if it's connected

Release 7

Symptoms: Been diagnosed with DKA and not sure why. This is the only new thing in my system.

Healthcare visit (other): Pcp follow up visit

Symptoms: Diabetes ketoacidosis. Glucose levels are super high with no explanation as to why. And I have blurred vision because of it.

Symptoms: Still dealing with DKA - diabetic ketoacidosis with vision loss.

Release 9

Symptoms: Diabetes 1.5 diagnosed after a diabetes 2 and diabetic ketoacidosis diagnosis. All occurred after the covid vaccine.

Release 10

Systemic reaction (other): Lump in underarm of the arm injection

Systemic reaction (other): Glucose spike

Symptoms: A cold of some sort. Severe congestion, headache and cough

Symptoms: A cold with runny nose and congestion. Not covid related in sure.

Release 11

Symptoms: Prolonged period. 45 days

Healthcare visit (other): Regular in office appointment

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	✓	✓	✓
SD	Blindness	✓	✓	✓
SD	Cough	·	·	✓
SD	Diabetic ketoacidosis	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Headache	·	·	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Type 2 diabetes mellitus	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Axillary mass	·	·	✓
SRO	Blood glucose increased	·	·	✓
SRO	Hot flush	✓	✓	✓

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