XYT-20144-20655

3 vaccinations 8 coded responses 40 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 903 / CA
Registered: 2021-03-05

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
1407945 (opens in a new window)	high	11 / 11	2	2 of 4 VAERS symptoms	same dose (2)	CA matches	2021-04-01 / 2021-04-02 / 2021-06-17 received the same day as the last call	case 649237

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Survey response — 0 day, dose 1
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Survey response — 14 day, dose 1
MedDRA: Injection site discolouration, Injection site erythema, Injection site rash, Injection site swelling — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-26
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-02
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)
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-08
Survey response — 7 day, dose 2
MedDRA: Injection site rash — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-15
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-04-22
Survey response — 21 day, dose 2
MedDRA: Injection site pruritus, Injection site warmth, Pruritus — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-01
Survey response — 28 day, dose 2
MedDRA: Asthma, Pre-existing disease, Throat tightness — 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
2021-05-01
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)
2021-05-06
Survey response — 35 day, dose 2
MedDRA: Dyspnoea, Wheezing — Feeling: Fair · Be unable to work, 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: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-06
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)
2021-05-13
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Call successful
Completed over the phone
2021-07-01
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2022-01-14
Dose 3 — Moderna
2022-01-14
Health check-in — 0 day, dose 3
Feeling: Poor · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-16
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Wheezing — Feeling: Poor · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-01-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-21
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2022-01-30
Health check-in — 14 day, dose 3
Feeling: Fair

Adult check-in
2022-02-04
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2022-02-11
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2022-02-18
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2022-02-25
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-04-15
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-07-17
Health check-in — 6 month, dose 3
Feeling: Fair

Adult check-in
2023-01-15
Health check-in — 12 month, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-01	Moderna
3	2022-01-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-02	Successful	Completed over the phone
2021-05-01	Successful	Completed over the phone
2021-05-06	Successful 2021-06-17	Completed over the phone

Free text

Release 5

Systemic reaction (other): No

Symptoms: The injection site developed a red raised rash about the size of a small peach, and now the rash is gone but it left dark colored skin in the shape of the rash

Release 7

Systemic reaction (other): Rash on the injection site

Systemic reaction (other): Rash at injection

Symptoms: Injection site itches on both arms and sometimes becomes warm

Release 8

Symptoms: Esophagus begin to close i was started on advere steroid inhaler and albuterol inhaler and i dont have asthma

Symptoms: Wheezing shortness of breath

Release 10

Systemic reaction (other): Wheezing coughing

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
SD	Asthma	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Injection site discolouration	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Throat tightness	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Injection site rash	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Wheezing	·	·	✓

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