YF3-15406-50781

2 vaccinations 6 coded responses 14 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 600 / IL
Registered: 2021-04-07

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
1372328 (opens in a new window)	high	11 / 11	1	4 of 5 VAERS symptoms	same dose (2)	IL matches	2021-04-05 / 2021-04-06 / 2021-06-03 received the same day as the last call	case 666569

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

2021-03-08
Dose 1 — Moderna
2021-04-05
Dose 2 — Moderna
2021-04-07
Registered in v-safe
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Ear swelling, Emergency care, Lip swelling, Medical counselling, Pyrexia, Self-medication, Swelling face — Feeling: Poor · Site: Pain · 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, Emergency room or emergency department visit

Free text: Systemic reaction (other): extreme allergic reaction, went to ER this morning. Lips and area above to nose, nose and area below lower lip all extremely swollen.. ER doc gave me benedryl, prednisone and pepsid to try to tame allergic response. Fever of 102 preceded this yesterday. · Healthcare visit (other): At first, talked to Walgreens Senior pharmacist night of April 4. He said take 20 ml liquid benedryl. I did at 10 pm on April 6. Morning of April 7, lips and general front of face and ears extremely swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
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)
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Lip swelling, Swelling face, Swelling of eyelid — Feeling: Fair · Headache · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Continued swelling of lips, area from lips to nose, area fromLips to chin, swollen ears and swollen cheeks and eyelids

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred, Visual impairment — Feeling: Poor · Site: Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Poor vision. Hard to focus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling face — Feeling: Good · Site: Swelling

Free text: Face swelling continues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Survey response — day 14, dose 2
MedDRA: Asthenia, Erythema, Extrasystoles, Fatigue, Feeling cold, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart palpitations. Weakness. Cheeks and nose red. Always cold. Fatigue. Heart skips beats even when resting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — day 35, dose 2
MedDRA: Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Heart palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Call 1 — Left Voicemail
2021-06-03
Call successful
Completed over the phone
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-07
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-07	Successful	Completed over the phone
2021-04-08	Successful	Completed over the phone
2021-05-10	Successful 2021-06-03	Completed over the phone

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): extreme allergic reaction, went to ER this morning. Lips and area above to nose, nose and area below lower lip all extremely swollen.. ER doc gave me benedryl, prednisone and pepsid to try to tame allergic response. Fever of 102 preceded this yesterday.

Healthcare visit (other): At first, talked to Walgreens Senior pharmacist night of April 4. He said take 20 ml liquid benedryl. I did at 10 pm on April 6. Morning of April 7, lips and general front of face and ears extremely swollen.

2021-04-08

Systemic reaction (other): Continued swelling of lips, area from lips to nose, area fromLips to chin, swollen ears and swollen cheeks and eyelids

2021-04-09

Systemic reaction (other): Poor vision. Hard to focus

2021-04-10

Systemic reaction (other): Face swelling continues.

Release 7 — day 14, dose 2

2021-04-19

Symptoms: Heart palpitations. Weakness. Cheeks and nose red. Always cold. Fatigue. Heart skips beats even when resting.

Release 8 — day 35, dose 2

2021-05-10

Symptoms: Heart palpitations

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	Ear swelling	✓	✓	✓
HCVO	Lip swelling	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Self-medication	✓	✓	✓
HCVO	Swelling face	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Extrasystoles	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling cold	✓	✓	✓
SD	Palpitations	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Swelling face	✓	✓	✓
SRO	Swelling of eyelid	✓	✓	✓
SRO	Vision blurred	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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