YV8-29434-67335

3 vaccinations 9 coded responses 14 check-ins 9 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 816 / CO
Registered: 2021-01-14

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
2165718 (opens in a new window)	high	11 / 11	3	2 of 4 VAERS symptoms	same dose (1)	CO matches	2021-01-13 / 2021-01-13 / 2022-03-08 received 403 days after the last call	case 129769

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

2021-01-13
Dose 1 — Moderna
2021-01-14
Registered in v-safe
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Syncope — Feeling: Poor · Chills, Fatigue or tiredness

Free text: Evidently fainted in bathroom during night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Hallucination, Headache, Musculoskeletal stiffness, Syncope — Feeling: Good · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: The 1st day 1-13 after I went to bed, I had hallucinations, and evidently fainted. I woke up on the bathroom floor and went back to bed. I had a terrible headache and stiff neck for the next 2 days. Fine by Sat. bed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Syncope — Feeling: Good · Fatigue or tiredness

Free text: Worry that fainting on evening of first vaccine will be repeated after second dose. I live alone.ne

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: Specialist consultation — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-29
Survey response — day 14, dose 1
MedDRA: Fatigue, Immunisation reaction, Neck pain, Specialist consultation, Syncope — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Continued fatigue. Also continued sore neck which may have been from fainting in bathroom the night of vaccine. · Healthcare visit (other): My cardiologist recommends not getting second vaccine due to need for benadryl after first dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Survey response — day 21, dose 1
MedDRA: Fear, Hypersensitivity, Specialist consultation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I continue to want the 2nd vaccination but since my cardiologist advised against it because I had an allergic reaction to the first vaccination I am fearful of having the 2nd one.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Dose 2 — Moderna
2021-02-17
Survey response — day 7, dose 2
MedDRA: Injection site pain, Self-medication — Feeling: Fair · Site: Pain · Headache

Free text: Ice pack cured pain at shot site. Took 10mg Claritin 2 hrs before shot which prevented throat congestion I experienced with 1st dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Call 1 — Left Voicemail
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Dose 3 — Moderna
2021-12-04
Survey response — 3 months, dose 3
MedDRA: Cardiac ablation, Confusional state, Heart rate increased, Rosacea, Unevaluable event — Feeling: Good · 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

Free text: Symptoms: Pimply rosacia outbreak on nose; sudden confusion on and off for over an hour; ablation for fast heartbeat. · Healthcare visit (other): Ablation; ct brain scan; carotid artery scan

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Report sent to call center — 3 months, 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-06
Call 1 — Left Voicemail
2022-03-05
Survey response — 6 months, dose 3
MedDRA: Exposure to SARS-CoV-2, Eye swelling, Lacrimation increased, Office visit, SARS-CoV-2 test negative — 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: Swollen teary eyes for 5 weeks; was in close contact with a friend for 2 weeks who contracted covid while we were together (tested positive), but I tested negative at 2 1/2 week interval. · Healthcare visit (other): Optomotrist

MedDRA releases: 2024-11 · check-in free text available
2022-03-05
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)
2022-03-08
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-09-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-18	Successful	Completed over the phone
2021-01-22	Successful	Completed over the phone
2021-01-29	Successful	Completed over the phone
2021-02-03	Successful	Completed over the phone
2021-12-04	Successful	Does not wish to fill out VAERS report
2022-03-05	Successful 2022-03-08	Does not wish to fill out VAERS report

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Evidently fainted in bathroom during night.

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): The 1st day 1-13 after I went to bed, I had hallucinations, and evidently fainted. I woke up on the bathroom floor and went back to bed. I had a terrible headache and stiff neck for the next 2 days. Fine by Sat. bed

2021-01-19

Systemic reaction (other): Worry that fainting on evening of first vaccine will be repeated after second dose. I live alone.ne

Release 2 — day 7, dose 1

2021-01-22

Healthcare visit (other): Cardiologist

Release 3 — day 14, dose 1

2021-01-29

Symptoms: Continued fatigue. Also continued sore neck which may have been from fainting in bathroom the night of vaccine.

Healthcare visit (other): My cardiologist recommends not getting second vaccine due to need for benadryl after first dose.

Release 3 — day 21, dose 1

2021-02-03

Symptoms: I continue to want the 2nd vaccination but since my cardiologist advised against it because I had an allergic reaction to the first vaccination I am fearful of having the 2nd one.

Release 4 — day 7, dose 2

2021-02-17

Systemic reaction (other): Ice pack cured pain at shot site. Took 10mg Claritin 2 hrs before shot which prevented throat congestion I experienced with 1st dose.

Release 10 — 3 months, dose 3

2021-12-04

Symptoms: Pimply rosacia outbreak on nose; sudden confusion on and off for over an hour; ablation for fast heartbeat.

Healthcare visit (other): Ablation; ct brain scan; carotid artery scan

Release 11 — 6 months, dose 3

2022-03-05

Symptoms: Swollen teary eyes for 5 weeks; was in close contact with a friend for 2 weeks who contracted covid while we were together (tested positive), but I tested negative at 2 1/2 week interval.

Healthcare visit (other): Optomotrist

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	Immunisation reaction	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Specialist consultation	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Cardiac ablation	·	·	✓
SD	Confusional state	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Eye swelling	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Fear	✓	✓	✓
SD	Heart rate increased	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Lacrimation increased	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Rosacea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Specialist consultation	✓	✓	✓
SD	Syncope	✓	✓	✓
SRO	Hallucination	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Syncope	✓	✓	✓

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