YXV-23012-03982

3 vaccinations 14 coded responses 35 check-ins 14 free-text entries 8 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 967 / HI
Registered: 2020-12-23

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
958751 (opens in a new window)	high	10 / 11	5	2 of 8 VAERS symptoms	same dose (1)	HI matches	2020-12-23 / 2020-12-23 / 2021-01-20 received the same day as the last call	case 52414

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2020-12-26
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia — Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-26
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Adult check-in
2020-12-27
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · 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, Outpatient clinic or urgent care clinic visit

Adult check-in
2020-12-28
Report sent to call center — days 1–6 daily, dose 1
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)
2020-12-30
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2020-12-30
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-12
Call 1 — Left Voicemail
2021-01-13
Survey response — day 21, dose 1
MedDRA: Dizziness, Pyrexia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness off and on Low grade fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-15
Call 1 — Left Voicemail
2021-01-20
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-20
Call successful
Completed over the phone
2021-01-28
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-02
Survey response — day 0, dose 2
MedDRA: Headache — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Base of skull pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Pain at base of skull

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Pain — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Pain at base of skull, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Headache, Skull fractured base — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Base of skull pain, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Headache — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · 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

Free text: Dizziness, pain at base of skull

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
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)
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Headache — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Dizziness, pain at the base of the skull

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
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)
2021-02-10
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness and pain at base of skull

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-16
Survey response — day 42, dose 2
MedDRA: Confusional state, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Severe headaches and confusion with words

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-14
Call 1 — Left Voicemail
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-03
Dose 3 — Moderna
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Toothache — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Teeth pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Acupuncture, Cupping therapy, Dizziness — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Dizziness · Healthcare visit (other): Acupuncture and cupping

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-09
Call 1 — Left Voicemail
2021-11-10
Health check-in — day 7, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-11-11
Call 2 — Could Not Reach Participant
2021-11-15
Call 3 — Left Voicemail
2021-11-15
Callback requested for
02:00PM ET
2021-11-24
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-02
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-11-03
Survey response — 12 months, dose 3
MedDRA: Adverse reaction — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I got side effects from my booster shot for covid and from my flu shot.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-02-02	Moderna
3	2021-11-03	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2020-12-26	Successful	Completed over the phone
2020-12-27	Successful	Completed over the phone
2020-12-28	Successful	Completed over the phone
2020-12-30	Successful	Completed over the phone
2021-01-13	Successful 2021-01-20	Completed over the phone
2021-02-07	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-02-08	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-11-05	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-26

Systemic reaction (other): Fever

Release 1 — day 21, dose 1

2021-01-13

Symptoms: Dizziness off and on Low grade fever

Release 3 — day 0, dose 2

2021-02-02

Systemic reaction (other): Base of skull pain

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Pain at base of skull

2021-02-05

Systemic reaction (other): Pain at base of skull, dizziness

2021-02-06

Systemic reaction (other): Base of skull pain, dizziness

2021-02-07

Systemic reaction (other): Dizziness, pain at base of skull

2021-02-08

Systemic reaction (other): Dizziness, pain at the base of the skull

Release 4 — day 7, dose 2

2021-02-10

Systemic reaction (other): Dizziness and pain at base of skull

Release 5 — day 42, dose 2

2021-03-16

Symptoms: Severe headaches and confusion with words

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): Teeth pain

2021-11-05

Systemic reaction (other): Dizziness

Healthcare visit (other): Acupuncture and cupping

2021-11-06

Systemic reaction (other): Dizziness

Release 12 — 12 months, dose 3

2022-11-03

Symptoms: I got side effects from my booster shot for covid and from my flu shot.

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	Acupuncture	·	·	✓
HCVO	Cupping therapy	·	·	✓
SD	Adverse reaction	·	·	✓
SD	Confusional state	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Skull fractured base	○	✓	○
SRO	Toothache	·	·	✓

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