YB4-23835-20597

4 vaccinations 6 coded responses 26 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 959 / CA
Registered: 2021-11-19

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
1912966 (opens in a new window)	high	10 / 11	-1	1 of 4 VAERS symptoms	same dose (2)	CA matches	2021-11-19 / 2021-11-22 / 2021-12-01 received the same day as the last call	case 1185666

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

2021-05-18
Dose 1 — Janssen/Johnson & Johnson
2021-11-19
Registered in v-safe
2021-11-19
Dose 2 — Moderna
2021-11-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-20
Survey response — days 1–6 daily, dose 2
MedDRA: Photophobia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Light sensitive eyes

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — days 1–6 daily, dose 2
MedDRA: Arrhythmia, Emergency care, Palpitations — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Cardiac arrhythmia went to ER · Healthcare visit (other): 1:30 am woke with pounding in chest, arrhythmias. Went to ER 3:30am. On the way, pulse returned to normal. At ER, EKG ok, blood lab ok, chest film ok and released.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-11-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-23
Call 1 — Left Voicemail
2021-11-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-29
Call 2 — Left Voicemail
2021-12-01
Call 3 — Left Voicemail
2021-12-01
Call successful
Completed over the phone
2021-12-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-24
Survey response — day 35, dose 2
MedDRA: Cough — Feeling: Good

Free text: Nighttime cough

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-02-18
Survey response — 3 months, dose 2
MedDRA: Body temperature increased, COVID-19, Headache, Malaise, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Covid positive Sick with headache and slight sore throat, raised temp for 2 days

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Survey response — 6 months, dose 2
MedDRA: Body temperature increased, COVID-19, Headache, Tongue coated — Feeling: Good · Be unable to do your normal daily activities

Free text: Had Covid a second time 1/7/22. Headache, temp 100F, three days, three days of Paxlovid which produced thick white coated tongue for two days.

MedDRA releases: 2024-11 · check-in free text available
2022-07-18
Dose 3 — Pfizer-BioNTech
2022-11-16
Dose 4 — Moderna
Co-administered: Pneumonia
2022-11-19
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-11-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-11-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-23
Health check-in — day 7, dose 4
Feeling: Good · Site: Swelling · None

Adult check-in
2022-11-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-21
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-15
Survey response — 3 months, dose 4
MedDRA: Cough, Nasopharyngitis, Productive cough — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-17
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-18	Janssen/Johnson & Johnson	No
2	2021-11-19	Moderna	No
3	2022-07-18	Pfizer-BioNTech	No
4	2022-11-16	Moderna	Pneumonia

Call center

Reported	Outcome	VAERS-related outcome
2021-11-22	Successful 2021-12-01	Completed over the phone

Free text

Release 10 — days 1–6 daily, dose 2

2021-11-20

Systemic reaction (other): Light sensitive eyes

2021-11-22

Systemic reaction (other): Cardiac arrhythmia went to ER

Healthcare visit (other): 1:30 am woke with pounding in chest, arrhythmias. Went to ER 3:30am. On the way, pulse returned to normal. At ER, EKG ok, blood lab ok, chest film ok and released.

Release 10 — day 35, dose 2

2021-12-24

Symptoms: Nighttime cough

Release 11 — 3 months, dose 2

2022-02-18

Symptoms: Covid positive Sick with headache and slight sore throat, raised temp for 2 days

Release 11 — 6 months, dose 2

2022-05-20

Symptoms: Had Covid a second time 1/7/22. Headache, temp 100F, three days, three days of Paxlovid which produced thick white coated tongue for two days.

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	Arrhythmia	·	·	✓
HCVO	Emergency care	·	·	✓
HCVO	Palpitations	·	·	✓
SD	Body temperature increased	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Productive cough	·	·	✓
SD	Tongue coated	·	·	✓
SRO	Arrhythmia	·	·	✓
SRO	Emergency care	·	·	✓
SRO	Photophobia	·	·	✓

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