ZAQ-38662-91678

4 vaccinations 16 coded responses 41 check-ins 15 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 622 / IL
Registered: 2021-01-21

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
2419292 (opens in a new window)	high	9 / 11	2	2 of 11 VAERS symptoms	same dose (4)	IL matches	2022-05-16 / 2022-05-20 / 2022-08-24 received 83 days before the last call	case 1172078

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

2021-01-21
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-21
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Flank pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain in lower left back to side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Myalgia — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Muscle pain lower left side of back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Left side of neck very sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — day 14, dose 2
MedDRA: Diarrhoea, Fatigue, Vomiting — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Diarrhea for two days, vomiting one morning, extreme fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 21, dose 2
MedDRA: Abdominal discomfort, Diarrhoea, Fatigue, Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Upset stomach, diarrhea, extreme fatigue, extreme reflux

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Left arm/shoulder is very sore. It was sore after the second shot but has gotten progressively worse over the last several weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-14
Dose 3 — Moderna
2022-02-19
Survey response — 12 months, dose 2
MedDRA: Diarrhoea, Kidney infection, Pyrexia, SARS-CoV-2 test negative, Sinusitis, Unevaluable event, Viral infection, Vomiting — 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 · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Severe virus 102 temp for 5 days, vomiting, diarrhea, sinus infection. Kidney infection a few week later. Covid testing was negative. No one else in household was symptomatic. · Healthcare visit (other): ER was recommended but I declined.

MedDRA releases: 2024-11 · check-in free text available
2022-02-19
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-25
Call successful
Participant prefers to complete VAERS report online
2022-03-15
Survey response — 6 months, dose 3
MedDRA: Nasopharyngitis, Respiratory tract congestion — Feeling: Fair

Free text: Severe congestion and cold-like symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Dose 4 — Moderna
2022-05-16
Health check-in — day 0, dose 4
Feeling: Good · Fever · None

Adult check-in
2022-05-17
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-20
Survey response — days 1–6 daily, dose 4
MedDRA: Anger, Crying, Depressed mood — Feeling: Good · Site: Pain

Free text: Have been crying a lot, depressed had rages 3 nights in a row, like something switched on. I just realized it could be related to this vaccine as my friends that had Covid all have been on anti-depressants and had similar symptoms after recovery.

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Survey response — days 1–6 daily, dose 4
MedDRA: Anxiety — Feeling: Good

Free text: Extreme anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Survey response — days 1–6 daily, dose 4
MedDRA: Anxiety — Feeling: Good

Free text: High anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-30
Survey response — day 14, dose 4
MedDRA: Alopecia — Feeling: Good

Free text: I am having extreme hair loss and had to buy a wig. I was told at the wig store that many people that had Covid vaccine or Covid are losing hair. They have seen a dramatic increase in business. I assume it's related to the vaccine but I don't know.

MedDRA releases: 2024-11 · check-in free text available
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
Survey response — 3 months, dose 4
MedDRA: Alopecia, Haemoglobin decreased, Office visit, Thyroid hormones decreased — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Thyroid is extreme low and hemoglobin is 5. Hair is falling out to the extreme. · Healthcare visit (other): Office visit and lab tests

MedDRA releases: 2024-11 · check-in free text available
2022-08-15
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-16
Call 1 — Requested Callback
2022-08-16
Call 1 — Requested Callback
2022-08-24
Call 2 — Could Not Reach Participant
2022-08-24
Callback requested for
11:20AM ET
2022-08-24
Call successful
Completed over the phone
2022-11-14
Survey response — 6 months, dose 4
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Possible kidney issues. Waiting for results of ultrasound ams 24 hour urine test. · Healthcare visit (other): Doctor's office

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-15
Call successful
Reported to VAERS during previous contact from GDIT
2023-05-18
Survey response — 12 months, dose 4
MedDRA: Office visit, Renal cyst, Renal impairment — Feeling: Poor · Be unable to work or attend school, 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
2023-05-18
Report sent to call center — 12 months, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-19
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-19	Moderna
3	2021-09-14	Moderna	No
4	2022-05-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-19	Successful 2022-02-25	Participant prefers to complete VAERS report online
2022-08-15	Successful 2022-08-24	Completed over the phone
2022-11-14	Successful 2022-11-15	Reported to VAERS during previous contact from GDIT
2023-05-18	Successful 2023-05-19	Completed over the phone

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): Pain in lower left back to side

2021-02-22

Systemic reaction (other): Muscle pain lower left side of back

2021-02-23

Systemic reaction (other): Left side of neck very sore

Release 5 — day 14, dose 2

2021-03-05

Symptoms: Diarrhea for two days, vomiting one morning, extreme fatigue.

Release 5 — day 21, dose 2

2021-03-12

Symptoms: Upset stomach, diarrhea, extreme fatigue, extreme reflux

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Left arm/shoulder is very sore. It was sore after the second shot but has gotten progressively worse over the last several weeks.

Release 11 — 12 months, dose 2

2022-02-19

Symptoms: Severe virus 102 temp for 5 days, vomiting, diarrhea, sinus infection. Kidney infection a few week later. Covid testing was negative. No one else in household was symptomatic.

Healthcare visit (other): ER was recommended but I declined.

Release 11 — 6 months, dose 3

2022-03-15

Symptoms: Severe congestion and cold-like symptoms.

Release 11 — days 1–6 daily, dose 4

2022-05-17

Systemic reaction (other): No

2022-05-20

Systemic reaction (other): Have been crying a lot, depressed had rages 3 nights in a row, like something switched on. I just realized it could be related to this vaccine as my friends that had Covid all have been on anti-depressants and had similar symptoms after recovery.

2022-05-21

Systemic reaction (other): Extreme anxiety

2022-05-22

Systemic reaction (other): High anxiety

Release 11 — day 14, dose 4

2022-05-30

Symptoms: I am having extreme hair loss and had to buy a wig. I was told at the wig store that many people that had Covid vaccine or Covid are losing hair. They have seen a dramatic increase in business. I assume it's related to the vaccine but I don't know. cut off by CDC

Release 12 — 3 months, dose 4

2022-08-15

Symptoms: Thyroid is extreme low and hemoglobin is 5. Hair is falling out to the extreme.

Healthcare visit (other): Office visit and lab tests

Release 12 — 6 months, dose 4

2022-11-14

Symptoms: Possible kidney issues. Waiting for results of ultrasound ams 24 hour urine test.

Healthcare visit (other): Doctor's office

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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Alopecia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Haemoglobin decreased	·	·	✓
SD	Kidney infection	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Renal cyst	·	·	✓
SD	Renal impairment	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	·	·	✓
SD	Thyroid hormones decreased	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Viral infection	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Anger	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Crying	·	·	✓
SRO	Depressed mood	·	·	✓
SRO	Flank pain	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	No adverse event	·	·	✓

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