YHS-25993-37832

5 vaccinations 15 coded responses 33 check-ins 13 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 926 / CA
Registered: 2021-01-27

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1663062 (opens in a new window)	high	8 / 11	1	1 of 4 VAERS symptoms	same dose (2)	CA matches	2021-02-20 / 2021-08-05 / 2021-09-01 received 251 days before the last call	case 955815

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

2021-01-26
Dose 1 — Moderna
2021-01-27
Registered in v-safe
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Taking ibuprofen and that helps.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Free text: Getting CT scan for shoulder. Might be rotator cuff.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good · Site: Redness · Diarrhea · Be unable to do your normal daily activities

Free text: Shoulder pain from rotator cuff..seeing doctor tomorrow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Muscle or body aches

Adult check-in
2021-02-27
Survey response — day 7, dose 2
MedDRA: Myalgia — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

Free text: Pain is from tear in rotator cuff.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — day 14, dose 2
MedDRA: Exostosis, Office visit, Pain, Rotator cuff syndrome — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Tear in rotator cuff-right arm and bone spur. Very painful. Waiting for cortisone injection. · Healthcare visit (other): In office visit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-21
Survey response — day 28, dose 2
MedDRA: Arthritis, Rotator cuff syndrome, Self-medication — Feeling: Fair · Be unable to do your normal daily activities

Free text: Right arm inflamed due to rotator cuff tear. Very painful. Taking ibuprofen and Tylenol. Plan on getting cortisone shot on Tuesday 3/23/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-21
Survey response — 6 months, dose 2
MedDRA: Office visit, Skin lesion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Found a lesion on my scalp. Had a biopsy 8/17/21..waiting for results. Might be cancer. · Healthcare visit (other): Dermatologist visit and primary care visit.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 1 — Left Voicemail
2021-11-03
Dose 3 — Moderna
2022-02-22
Survey response — 12 months, dose 2
MedDRA: Basal cell carcinoma, Chest X-ray abnormal, Computerised tomogram abnormal, Drug hypersensitivity, Pre-existing disease — Feeling: Good

Free text: Had biopsy and removal for basal cell skin cancer on my Head in August. Had CT scan chest X-ray which indicated some activity. Had bronchoscopy on 02/18/22. Will see doctor for results on 02/24/22.Also had allergy to diabetes medication.

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Dose 4 — Moderna
2022-04-24
Survey response — day 21, dose 4
MedDRA: Rotator cuff syndrome, Tendon pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Have tear in rotator cuff. Received cortisone injection on April 6,2022. Doctor was worried about my having received booster on April 1, 2022 and gave me injection in another area. Rotator cuff started hurting on April 10,2022 and still hurts.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-06
Survey response — day 35, dose 4
MedDRA: Contusion, Fall, Fibula fracture, Joint swelling — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Fell down some stairs and have a fracture on my fibula neck on my right leg. Ankle is swollen and whole leg is badly bruised.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-10
Call 1 — Left Voicemail
2022-05-10
Call successful
Completed over the phone
2022-05-10
Call successful
Completed over the phone
2022-05-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-02
Survey response — 6 months, dose 4
MedDRA: Diabetes mellitus, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with Diabetes. Trying to do more walking and watching diet. Will be rechecked middle of October to see if I need insulin. Worried about getting new vaccine until I get insulin or a new medication. · Healthcare visit (other): Dr. Visit in office

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-03
Call 1 — Could Not Reach Participant
2022-10-06
Call 2 — Left Voicemail
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Dose 5 — Moderna
2022-12-01
Survey response — day 35, dose 5
MedDRA: Arthralgia, Emergency care, Rotator cuff syndrome — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization

Free text: Had cortisone shot on 10/6/22 for tear in rotator cuff in right arm. On 11/14/22 had extreme pain in shoulder and was prescribed Tramadol. After a week of pain continued went to Emergency Room on 11/25/22. On 11/28/22 went to ER and then hospital.

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — day 35, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-12-02
Call 1 — Left Voicemail
2022-12-02
Call successful
Completed over the phone
2022-12-08
Survey response — day 42, dose 5
MedDRA: Diabetes mellitus, Hypoacusis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have a hearing implant in my left ear. It's called Envoy/Esteem. I'm not hearing well and seeing audiologist next week to see if it's the battery or something else. Also was diagnosed with Diabetes. · Healthcare visit (other): Audiologist visit

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-09
Call successful
Completed over the phone
2023-01-28
Survey response — 3 months, dose 5
MedDRA: Arthralgia, Back pain, Office visit — Feeling: Poor · 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: 2024-11
2023-01-28
Report sent to call center — 3 months, dose 5
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)
2023-01-30
Call 1 — Left Voicemail
2023-04-27
Survey response — 6 months, dose 5
MedDRA: Bronchitis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-27
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-28
Call 2 — Left Voicemail
2023-04-28
Call 1 — Left Voicemail
2023-05-05
Call successful
Reported to VAERS during previous contact from GDIT
2023-05-05
Call successful
Reported to VAERS during previous contact from GDIT

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-20	Moderna
3	2021-11-03	Moderna	No
4	2022-04-01	Moderna	No
5	2022-10-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-06	Successful 2022-05-10	Completed over the phone
2021-08-21	Successful 2022-05-10	Completed over the phone
2022-05-06	Successful 2022-05-10	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-02	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-01	Successful 2022-12-02	Completed over the phone
2022-12-08	Successful 2022-12-09	Completed over the phone
2023-01-28	Successful 2023-05-05	Reported to VAERS during previous contact from GDIT
2023-04-27	Successful 2023-05-05	Reported to VAERS during previous contact from GDIT

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Taking ibuprofen and that helps.

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): Getting CT scan for shoulder. Might be rotator cuff.

2021-02-24

Systemic reaction (other): Shoulder pain from rotator cuff..seeing doctor tomorrow.

Release 4 — day 7, dose 2

2021-02-27

Systemic reaction (other): Pain is from tear in rotator cuff.

Release 5 — day 14, dose 2

2021-03-06

Symptoms: Tear in rotator cuff-right arm and bone spur. Very painful. Waiting for cortisone injection.

Healthcare visit (other): In office visit.

Release 6 — day 28, dose 2

2021-03-21

Symptoms: Right arm inflamed due to rotator cuff tear. Very painful. Taking ibuprofen and Tylenol. Plan on getting cortisone shot on Tuesday 3/23/21.

Release 9 — 6 months, dose 2

2021-08-21

Symptoms: Found a lesion on my scalp. Had a biopsy 8/17/21..waiting for results. Might be cancer.

Healthcare visit (other): Dermatologist visit and primary care visit.

Release 11 — 12 months, dose 2

2022-02-22

Symptoms: Had biopsy and removal for basal cell skin cancer on my Head in August. Had CT scan chest X-ray which indicated some activity. Had bronchoscopy on 02/18/22. Will see doctor for results on 02/24/22.Also had allergy to diabetes medication.

Release 11 — day 21, dose 4

2022-04-24

Symptoms: Have tear in rotator cuff. Received cortisone injection on April 6,2022. Doctor was worried about my having received booster on April 1, 2022 and gave me injection in another area. Rotator cuff started hurting on April 10,2022 and still hurts.

Release 11 — day 35, dose 4

2022-05-06

Symptoms: Fell down some stairs and have a fracture on my fibula neck on my right leg. Ankle is swollen and whole leg is badly bruised.

Release 12 — 6 months, dose 4

2022-10-02

Symptoms: Diagnosed with Diabetes. Trying to do more walking and watching diet. Will be rechecked middle of October to see if I need insulin. Worried about getting new vaccine until I get insulin or a new medication.

Healthcare visit (other): Dr. Visit in office

Release 12 — day 35, dose 5

2022-12-01

Symptoms: Had cortisone shot on 10/6/22 for tear in rotator cuff in right arm. On 11/14/22 had extreme pain in shoulder and was prescribed Tramadol. After a week of pain continued went to Emergency Room on 11/25/22. On 11/28/22 went to ER and then hospital.

Release 12 — day 42, dose 5

2022-12-08

Symptoms: I have a hearing implant in my left ear. It's called Envoy/Esteem. I'm not hearing well and seeing audiologist next week to see if it's the battery or something else. Also was diagnosed with Diabetes.

Healthcare visit (other): Audiologist visit

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	Office visit	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	✓	✓	✓
SD	Back pain	·	·	✓
SD	Basal cell carcinoma	·	·	✓
SD	Bronchitis	·	·	✓
SD	Chest X-ray abnormal	·	·	✓
SD	Computerised tomogram abnormal	·	·	✓
SD	Contusion	·	·	✓
SD	Diabetes mellitus	·	·	✓
SD	Drug hypersensitivity	·	·	✓
SD	Emergency care	·	·	✓
SD	Exostosis	✓	✓	✓
SD	Fall	·	·	✓
SD	Fibula fracture	·	·	✓
SD	Hypoacusis	·	·	✓
SD	Joint swelling	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rotator cuff syndrome	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Skin lesion	✓	·	✓
SD	Tendon pain	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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