XXD-58308-80474

4 vaccinations 11 coded responses 54 check-ins 10 free-text entries 5 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 532 / WI
Registered: 2021-03-18

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
1909530 (opens in a new window)	high	11 / 11	—	3 of 4 VAERS symptoms	same dose (3)	WI matches	2021-11-15 / 2021-11-20 / 2021-11-30 received the same day as the last call	case 1194760

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-18
Health check-in — 0 day, dose 1
Feeling: Good · Site: Pain · Headache, Diarrhea

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — 7 day, dose 1
Feeling: Fair · Headache

Adult check-in
2021-04-01
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-04-15
Health check-in — 28 day, dose 1
Feeling: Fair

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Diarrhea

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Palpitations — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Arrhythmia, Atrial tachycardia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-21
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial tachycardia, Tachycardia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-22
Report sent to call center — days 1–6 daily, 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)
2021-04-24
Health check-in — 7 day, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-30
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-07-16
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-15
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-11-15
Dose 3 — Moderna
Co-administered: Tetanus
2021-11-15
Health check-in — 0 day, dose 3
Feeling: Good · None

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-17
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Nasopharyngitis — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-22
Health check-in — 7 day, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-29
Survey response — 14 day, dose 3
MedDRA: Bronchitis viral, Telemedicine — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2021-11-29
Report sent to call center — 14 day, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-30
Call successful
Completed over the phone
2021-11-30
Call successful
Completed over the phone
2021-11-30
Call successful
Completed over the phone
2021-12-06
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-12-27
Survey response — 42 day, dose 3
MedDRA: Diarrhoea, Fatigue, Headache, Sinus congestion — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2021-12-27
Report sent to call center — 42 day, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-28
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-02-14
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-05-16
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-11-04
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-11-04
Health check-in — 0 day, dose 4
Feeling: Good · None

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-11-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-09
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-11-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-11-11
Health check-in — 7 day, dose 4
Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-11-18
Survey response — 14 day, dose 4
MedDRA: Dyspnoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-11-25
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-12-02
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-12-09
Survey response — 35 day, dose 4
MedDRA: Ageusia, Cough, Diarrhoea, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative, Sinus congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-12-16
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2023-02-03
Survey response — 3 month, dose 4
MedDRA: Nephrolithiasis — Feeling: Fair · Be unable to work or attend school, 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: 2024-11 · check-in answers available
2023-02-03
Report sent to call center — 3 month, 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

Emergency room or emergency department visit · 1 call case(s)
2023-02-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-05
Health check-in — 6 month, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-16	Moderna
3	2021-11-15	Moderna	Tetanus
4	2022-11-04	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-04-21	Successful 2021-11-30	Completed over the phone
2021-04-22	Successful 2021-11-30	Completed over the phone
2021-11-29	Successful 2021-11-30	Completed over the phone
2021-12-27	Successful 2021-12-28	Reported to VAERS voluntarily prior to GDIT contact
2023-02-03	Successful 2023-02-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7

Systemic reaction (other): Mental fogginess (difficulty remembering & focusing)

Systemic reaction (other): Sore throat, heart palpitations

Systemic reaction (other): Heart arrhythmia (atrial tachycardia)

Systemic reaction (other): Atrial tachycardia

Healthcare visit (other): Outpatient procedure to correct tachycardia

Release 10

Systemic reaction (other): Sore throat

Systemic reaction (other): Suspecting common cold. Unlikely my booster had anything to do with this.

Symptoms: Suspected case of viral bronchitis (via e-visit with dr)

Symptoms: Sinus congestion, diarrhea, headache, fatigue

Release 12

Symptoms: Increased fatigue and shortness of breath.

Symptoms: Chest congestion, diarrhea, loss of taste, sinus congestion, cough, fever. Consist negative COVID test result (home test every 2 days).

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	Tachycardia	✓	✓	✓
SD	Ageusia	·	·	✓
SD	Bronchitis viral	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Telemedicine	·	·	✓
SRO	Arrhythmia	✓	✓	✓
SRO	Atrial tachycardia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Nasopharyngitis	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Palpitations	✓	✓	✓

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