Y7W-29140-25066

5 vaccinations 13 coded responses 47 check-ins 12 free-text entries 8 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 926 / CA
Registered: 2021-04-29

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
1662835 (opens in a new window)	high	10 / 11	3	4 of 9 VAERS symptoms	same dose (2)	CA matches	2021-05-19 / 2021-08-25 / 2021-09-01 received 6 days after the last call	case 947054

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

2021-04-28
Dose 1 — Pfizer-BioNTech
2021-04-29
Registered in v-safe
2021-04-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-04-30
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Headache, Neck pain, Self-medication, Unevaluable event — Feeling: Fair · Headache, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Severe headache contractions with throbbing and neck pain. Dizziness. Took Baclofen and Imitrix mild to moderate relief. · Healthcare visit (other): Rx for Naproxen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-12
Survey response — day 14, dose 1
MedDRA: Discomfort, Pre-existing disease, Rash, Rash macular — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have odd looking dark spots on my stomach and I am uncertain if they are related to the vaccine, Raynaud's phenomenon or Lipedema. Slight rash and discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Dose 2 — Pfizer-BioNTech
2021-05-19
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Abdominal pain

Adult check-in
2021-05-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-05-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-05-23
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Neck stiffness (ongoing) that may not be related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — days 1–6 daily, dose 2
MedDRA: Disorientation — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Feeling disoriented all weekend.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Disorientation, Malaise, Nausea — Feeling: Fair · Abdominal pain · Be unable to do your normal daily activities

Free text: Overall sickness for 3 days, slight nausea, abdominal cramps, and disoriented, which may or not be related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-06-02
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-09
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-30
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-18
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Haemoptysis, Pre-existing disease, Wheezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Wheezing, coughing and shortness of breath. I have asthma.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-25
Call 1 — Left Voicemail
2021-08-26
Call successful
Not applicable - Accidental Reporting
2021-08-26
Call successful
Completed over the phone
2021-09-01
Call 2 — Requested Callback
2021-09-01
Callback requested for
03:15PM ET
2021-11-19
Survey response — 6 months, dose 2
MedDRA: Arthropod bite, COVID-19, Home care, Medical counselling, Office visit, Wound treatment — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Delta variant in 8.25.2021 Brown Recluse Spider bite and would on 9.19.2021 (weekly wound care) · Healthcare visit (other): In-home medical care and weekly Wound Care Center

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · 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 · 1 call case(s)
2021-11-22
Call 1 — Left Voicemail
2021-12-22
Dose 3 — Moderna
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-27
Survey response — days 1–6 daily, dose 3
MedDRA: Asthenia, Unevaluable event — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Equilibrium and feeling slightly weak.

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-05
Survey response — day 14, dose 3
MedDRA: Pre-existing disease — 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

Free text: Major migraine headaches and I am still experiencing a loss of smell and taste since testing positive for the Delta variant on 8.25.2021.

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Report sent to call center — day 14, 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)
2022-01-07
Call 1 — Left Voicemail
2022-01-12
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-19
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-26
Health check-in — day 35, dose 3
Feeling: Good

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

Adult check-in
2022-03-23
Survey response — 3 months, dose 3
MedDRA: Office visit, Unevaluable event — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, 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

Free text: Symptoms: Unrelated to vaccine. Saw a colorectal surgeon. · Healthcare visit (other): CT Scan with contrast

MedDRA releases: 2024-11 · check-in free text available
2022-03-23
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-03-28
Call successful
Reported to VAERS during previous contact from GDIT
2022-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-22
Survey response — 6 months, dose 3
MedDRA: Medical counselling, Tremor — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Facial tremors, neither the neurologist nor I know their origin.

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-23
Call 1 — Could Not Reach Participant
2022-06-28
Call 2 — Could Not Reach Participant
2022-07-26
Dose 4 — Moderna
2022-10-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-25
Dose 5 — Moderna
2022-11-25
Health check-in — day 0, dose 5
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2022-11-26
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-11-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Swelling · Abdominal pain

Adult check-in
2022-11-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Swelling · Headache, Abdominal pain

Adult check-in
2022-12-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache, Diarrhea

Adult check-in
2022-12-02
Health check-in — day 7, dose 5
Feeling: Good · Headache

Adult check-in
2022-12-09
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-16
Survey response — day 21, dose 5
MedDRA: Blood urine present, Protein urine, Renal disorder, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Kidney or possible UTI concern: blood and protein found in urine sample.

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Report sent to call center — day 21, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-20
Call 3 — Requested Callback
2022-12-20
Call 1 — Requested Callback
2022-12-21
Call X — Could Not Reach Participant
2022-12-21
Call 2 — Could Not Reach Participant
2022-12-21
Callback requested for
01:00PM ET
2022-12-23
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-30
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-01-06
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-24
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-26
Survey response — 6 months, dose 5
MedDRA: Asthma, Condition aggravated, Pre-existing disease, Respiratory tract congestion — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-26
Call case (no matching report) — Successful
Participant prefers to complete VAERS report online
2023-05-30
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-30
Call successful
Participant prefers to complete VAERS report online
2023-05-30
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-28	Pfizer-BioNTech
2	2021-05-19	Pfizer-BioNTech
3	2021-12-22	Moderna	No
4	2022-07-26	Moderna	No
5	2022-11-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-30	Successful 2021-08-26	Not applicable - Accidental Reporting
2021-08-18	Successful 2021-08-26	Completed over the phone
2021-11-19	Successful 2022-03-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-05	Successful 2022-03-28	Reported to VAERS during previous contact from GDIT
2022-03-23	Successful 2022-03-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-22	Successful 2023-05-30	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-16	Successful 2023-05-30	Participant prefers to complete VAERS report online
2023-05-26	Successful 2023-05-30	Participant prefers to complete VAERS report online

Free text

Release 8 — days 1–6 daily, dose 1

2021-04-30

Systemic reaction (other): Severe headache contractions with throbbing and neck pain. Dizziness. Took Baclofen and Imitrix mild to moderate relief.

Healthcare visit (other): Rx for Naproxen.

Release 8 — day 14, dose 1

2021-05-12

Symptoms: I have odd looking dark spots on my stomach and I am uncertain if they are related to the vaccine, Raynaud's phenomenon or Lipedema. Slight rash and discomfort.

Release 8 — days 1–6 daily, dose 2

2021-05-23

Systemic reaction (other): Neck stiffness (ongoing) that may not be related to the vaccine.

2021-05-24

Systemic reaction (other): Feeling disoriented all weekend.

2021-05-25

Systemic reaction (other): Overall sickness for 3 days, slight nausea, abdominal cramps, and disoriented, which may or not be related to the vaccine.

Release 9 — 3 months, dose 2

2021-08-18

Symptoms: Wheezing, coughing and shortness of breath. I have asthma.

Release 10 — 6 months, dose 2

2021-11-19

Symptoms: Delta variant in 8.25.2021 Brown Recluse Spider bite and would on 9.19.2021 (weekly wound care)

Healthcare visit (other): In-home medical care and weekly Wound Care Center

Release 10 — days 1–6 daily, dose 3

2021-12-27

Systemic reaction (other): Equilibrium and feeling slightly weak.

Release 10 — day 14, dose 3

2022-01-05

Symptoms: Major migraine headaches and I am still experiencing a loss of smell and taste since testing positive for the Delta variant on 8.25.2021.

Release 11 — 3 months, dose 3

2022-03-23

Symptoms: Unrelated to vaccine. Saw a colorectal surgeon.

Healthcare visit (other): CT Scan with contrast

Release 12 — 6 months, dose 3

2022-06-22

Symptoms: Facial tremors, neither the neurologist nor I know their origin.

Release 12 — day 21, dose 5

2022-12-16

Symptoms: Kidney or possible UTI concern: blood and protein found in urine sample.

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	Home care	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthropod bite	·	·	✓
SD	Asthma	·	·	✓
SD	Blood urine present	·	·	✓
SD	Condition aggravated	·	·	✓
SD	COVID-19	·	·	✓
SD	Discomfort	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SD	Haemoptysis	✓	·	✓
SD	Medical counselling	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Protein urine	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Renal disorder	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Tremor	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Wheezing	✓	·	✓
SD	Wound treatment	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Asthenia	·	·	✓
SRO	Disorientation	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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