YP4-24501-98763

5 vaccinations 7 coded responses 40 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 805 / CO
Registered: 2021-01-04

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
1411281 (opens in a new window)	high	9 / 11	4	3 of 14 VAERS symptoms	same dose (2)	CO matches	2021-02-11 / 2021-02-16 / 2021-06-18 received the same day as the last call	case 256552

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Moderna
2021-01-04
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Survey response — day 21, dose 1
MedDRA: Atrial fibrillation, Chest discomfort, Chest pain, Cough, Dyspnoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Two A-Fib episodes (Tuesday and Friday) followed by tightness in chest, get out of breath quickly, cannot take deep breaths (when I do, stabbing pain on right side of breast bone), and cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — day 28, dose 1
MedDRA: Chest X-ray, Dyspnoea, Respiratory tract congestion, SARS-CoV-2 test positive — 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: Symptoms: Chest congestion and difficulty breathing. · Healthcare visit (other): Plus Covid test and chest X-ray.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Report sent to call center — day 28, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-08
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-25
Survey response — day 14, dose 2
MedDRA: Ageusia, Anosmia, Body temperature increased, Chills, Fatigue — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Acute dystolic congestive heart failure with all the symptoms of Covid except the loss of taste a smell. Originally thought it was an adverse reaction to second Covid vaccination on Feb 11, five days before chills, elevate temperature and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 14, 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)
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-18
Call 1 — Left Voicemail
2021-06-18
Call successful
Completed over the phone
2021-06-18
Call successful
Completed over the phone
2021-08-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-16
Dose 3 — Moderna
2022-02-11
Survey response — 12 months, dose 2
MedDRA: Urinary tract infection — 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 · Emergency room or emergency department visit

Free text: Urinary track infection.

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-02-15
Call successful
Reported to VAERS during previous contact from GDIT
2022-05-16
Dose 4 — Moderna
2022-05-16
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-17
Survey response — days 1–6 daily, dose 4
MedDRA: Confusional state, Cough, Rhinorrhoea, Unevaluable event — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Free text: Systemic reaction (other): Runny nose. Cough. Confusion · Healthcare visit (other): Took rapid antigen test. Negative but wil do another test tomorrow. Canceled previously scheduledl office visit

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Report sent to call center — days 1–6 daily, dose 4
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 · 1 call case(s)
2022-05-18
Survey response — days 1–6 daily, dose 4
MedDRA: Rhinorrhoea — Feeling: Good · Site: Pain, Itching

Free text: Runny nose.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Call 1 — Left Voicemail
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-23
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-15
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-14
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-12-15
Dose 5 — Moderna
2023-06-15
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-11	Moderna
3	2021-11-16	Moderna	No
4	2022-05-16	Moderna	No
5	2022-12-15	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-01	Successful 2021-06-18	Completed over the phone
2021-02-25	Successful 2021-06-18	Completed over the phone
2022-02-11	Successful 2022-02-15	Reported to VAERS during previous contact from GDIT
2022-05-17	Successful 2022-05-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 2 — day 21, dose 1

2021-01-25

Symptoms: Two A-Fib episodes (Tuesday and Friday) followed by tightness in chest, get out of breath quickly, cannot take deep breaths (when I do, stabbing pain on right side of breast bone), and cough.

Release 3 — day 28, dose 1

2021-02-01

Symptoms: Chest congestion and difficulty breathing.

Healthcare visit (other): Plus Covid test and chest X-ray.

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): Confusion

Release 4 — day 14, dose 2

2021-02-25

Symptoms: Acute dystolic congestive heart failure with all the symptoms of Covid except the loss of taste a smell. Originally thought it was an adverse reaction to second Covid vaccination on Feb 11, five days before chills, elevate temperature and fatigue. cut off by CDC

Release 11 — 12 months, dose 2

2022-02-11

Symptoms: Urinary track infection.

Release 11 — days 1–6 daily, dose 4

2022-05-17

Systemic reaction (other): Runny nose. Cough. Confusion

Healthcare visit (other): Took rapid antigen test. Negative but wil do another test tomorrow. Canceled previously scheduledl office visit

2022-05-18

Systemic reaction (other): Runny nose.

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	Chest X-ray	✓	✓	✓
HCVO	SARS-CoV-2 test positive	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Atrial fibrillation	✓	✓	✓
SD	Body temperature increased	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SRO	Confusional state	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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