ZSZ-33504-60743

3 vaccinations 7 coded responses 17 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 921 / CA
Registered: 2021-02-08

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
2263935 (opens in a new window)	high	10 / 11	—	5 of 17 VAERS symptoms	same dose (3)	CA matches	2021-10-19 / 2022-03-19 / 2022-05-04 received the same day as the last call	case 562630

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

2021-01-27
Dose 1 — Moderna
2021-02-08
Registered in v-safe
2021-02-08
Survey response — day 7, dose 1
MedDRA: Injection site erythema — Feeling: Good · Site: Redness

Free text: I had my shot on January 27th. However, the redness at the shot site didn't appear until 3 days ago, and is getting larger.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Survey response — day 14, dose 2
MedDRA: Inflammation — 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

Free text: A urine inflammation started approximately 2weeks ago. My doctor was deeply concerned and surprised; possibly to 2nd Moderna Vaccine. Another individual I was told had the same experience and died. He was 80; I'm 70.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 21, dose 2
MedDRA: Cystitis noninfective, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I continue to have bladder inflammation since shortly after my 2nd dose. I went to give my urine sample to the lab today. · Healthcare visit (other): Lab at a (b)(6) Clinic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Survey response — day 28, dose 2
MedDRA: Urinary tract inflammation — 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

Free text: Urinary Inflammation shortly after February 25th, 2nd Covid Shot. Still a major problem.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Dose 3 — Moderna
2021-11-02
Survey response — day 14, dose 3
MedDRA: Abdominal pain upper, Diarrhoea, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Stomach hurts, stabbing pains, and diarrhea · Healthcare visit (other): Made an appointment

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-04
Call 1 — Left Voicemail
2021-11-09
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-23
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-30
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-18
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Dizziness, Fatigue, Pre-existing disease, Rhinorrhoea, Vomiting — Feeling: Fair

Free text: I was moving to a new residence. I had a runny nose, which I never do, dizziness, diarrhea, vomited, fatigued more so. These symptoms, except for runny nose I experience with my other health issues. I had these symptoms when moving. Forced to move

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Survey response — 6 months, dose 3
MedDRA: COVID-19, Cough, Fatigue, Night sweats, Unevaluable event — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I contracted COVID March 19, 2022. I'm still having symptoms of fatigue, coughing, and night sweats. I am improving. · Healthcare visit (other): I received a monoclonal therapy treatment.

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Report sent to call center — 6 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-22
Call 1 — Could Not Reach Participant
2022-04-27
Call 2 — Requested Callback
2022-04-29
Call 3 — Requested Callback
2022-05-04
Call successful
Does not wish to fill out VAERS report
2022-05-04
Call successful
Does not wish to fill out VAERS report
2022-05-04
Call successful
Does not wish to fill out VAERS report
2022-05-04
Call successful
Completed over the phone
2022-05-04
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-25	Moderna
3	2021-10-19	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-13	Successful 2022-05-04	Does not wish to fill out VAERS report
2021-03-19	Successful 2022-05-04	Does not wish to fill out VAERS report
2021-03-25	Successful 2022-05-04	Does not wish to fill out VAERS report
2021-11-02	Successful 2022-05-04	Completed over the phone
2022-04-21	Successful 2022-05-04	Completed over the phone

Free text

Release 3 — day 7, dose 1

2021-02-08

Systemic reaction (other): I had my shot on January 27th. However, the redness at the shot site didn't appear until 3 days ago, and is getting larger.

Release 5 — day 14, dose 2

2021-03-13

Symptoms: A urine inflammation started approximately 2weeks ago. My doctor was deeply concerned and surprised; possibly to 2nd Moderna Vaccine. Another individual I was told had the same experience and died. He was 80; I'm 70.

Release 5 — day 21, dose 2

2021-03-19

Symptoms: I continue to have bladder inflammation since shortly after my 2nd dose. I went to give my urine sample to the lab today.

Healthcare visit (other): Lab at a (b)(6) Clinic

redacted (b)(6)

Release 6 — day 28, dose 2

2021-03-25

Symptoms: Urinary Inflammation shortly after February 25th, 2nd Covid Shot. Still a major problem.

Release 10 — day 14, dose 3

2021-11-02

Symptoms: Stomach hurts, stabbing pains, and diarrhea

Healthcare visit (other): Made an appointment

Release 10 — 3 months, dose 3

2022-01-18

Symptoms: I was moving to a new residence. I had a runny nose, which I never do, dizziness, diarrhea, vomited, fatigued more so. These symptoms, except for runny nose I experience with my other health issues. I had these symptoms when moving. Forced to move

Release 11 — 6 months, dose 3

2022-04-21

Symptoms: I contracted COVID March 19, 2022. I'm still having symptoms of fatigue, coughing, and night sweats. I am improving.

Healthcare visit (other): I received a monoclonal therapy treatment.

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 pain upper	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Cystitis noninfective	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Inflammation	✓	✓	✓
SD	Night sweats	·	·	✓
SD	Office visit	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Urinary tract inflammation	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Injection site erythema	✓	✓	✓

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