263-24269-09016

4 vaccinations 9 coded responses 23 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 21-25
ZIP prefix: 548 / WI
Registered: 2021-01-18

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

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-18
Registered in v-safe
2021-01-19
Dose 1 — Pfizer-BioNTech
2021-01-19
Survey response — day 0, dose 1
MedDRA: Flatulence — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Gassiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Dysmenorrhoea, Menstruation irregular — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: May not be related, but my period started early the day of the vaccine and my period symptoms are significantly worse than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Poor · 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: Poor

Adult check-in
2021-02-09
Dose 2 — Pfizer-BioNTech
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dysmenorrhoea, Menstrual disorder — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Im currently on two forms of birth control (the IUD and oral birth control pills) and even though I am taking the regular birth control pills and NOT the sugar pills right now, I still got my period. My period is also a week early and I had some pretty intense cramping around my pelvic region. This happened with my first dose as well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — day 21, dose 2
MedDRA: Limb mass — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sudden lump in my left leg, getting an ultrasound to look at it this next Wednesday.

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

1 call case(s)
2021-03-09
Survey response — day 28, dose 2
MedDRA: Back pain, Peripheral swelling — 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: Lump in my leg that wasnt due to accident or injury, severe lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
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)
2021-03-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-11
Survey response — 3 months, dose 2
MedDRA: Back pain, Condition aggravated, Headache, Pain in extremity, Pre-existing disease — 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, Emergency room or emergency department visit

Free text: Increasing back pain (possibly sciatica), leg pain in one leg, increasing amount and intensity of headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Call successful
Does not wish to fill out VAERS report
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Tic — 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: Motor tics

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-15
Call 1 — Left Voicemail
2021-11-13
Dose 3 — Moderna
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Dyspnoea, Nasopharyngitis, Respiratory tract congestion — Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, congestion, shortness of breath (I have a cold, however, so this likely isn't due to the booster)

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-14
Survey response — 6 months, dose 3
MedDRA: Dyspnoea — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-17
Call 1 — Left Voicemail
2022-09-04
Dose 4 — Moderna
2022-09-04
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-09-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Pfizer-BioNTech
2	2021-02-09	Pfizer-BioNTech
3	2021-11-13	Moderna	No
4	2022-09-04	Moderna	No

Call center

5 call center cases

3 successful · 2 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-19

Systemic reaction (other): Gassiness

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): May not be related, but my period started early the day of the vaccine and my period symptoms are significantly worse than usual.

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Im currently on two forms of birth control (the IUD and oral birth control pills) and even though I am taking the regular birth control pills and NOT the sugar pills right now, I still got my period. My period is also a week early and I had some pretty intense cramping around my pelvic region. This happened with my first dose as well.

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Sudden lump in my left leg, getting an ultrasound to look at it this next Wednesday.

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Lump in my leg that wasnt due to accident or injury, severe lower back pain

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: Increasing back pain (possibly sciatica), leg pain in one leg, increasing amount and intensity of headaches

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Motor tics

Release 10 — days 1–6 daily, dose 3

2021-11-15

Systemic reaction (other): Cough, congestion, shortness of breath (I have a cold, however, so this likely isn't due to the booster)

Release 11 — 6 months, dose 3

2022-05-14

Symptoms: Shortness of breath

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
SD	Back pain	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Headache	✓	✓	✓
SD	Limb mass	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Tic	✓	·	✓
SRO	Cough	·	·	✓
SRO	Dysmenorrhoea	✓	✓	✓
SRO	Dyspnoea	·	·	✓
SRO	Flatulence	✓	✓	✓
SRO	Menstrual disorder	✓	✓	✓
SRO	Menstruation irregular	✓	✓	✓
SRO	Nasopharyngitis	·	·	✓
SRO	Respiratory tract congestion	·	·	✓

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