2FB-16862-22611
4 vaccinations
8 coded responses
43 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 641 / MO
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Pfizer-BioNTech
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Malaise — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: General malaiseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-28
-
2021-02-04
Dose 2 — Pfizer-BioNTech
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-08
- 2021-02-10
-
2021-02-11
Health check-in — day 7, dose 2Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-05-06
- 2021-08-05
-
2021-10-05
Dose 3 — Pfizer-BioNTech
- 2021-10-05
-
2021-10-06
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-09
- 2021-10-10
-
2021-10-11
Survey response — days 1–6 daily, dose 3MedDRA: Allergic respiratory symptom — Feeling: Fair · Headache, Fatigue or tirednessFree text: Allergy Symptoms- likely due to weatherMedDRA releases: 2024-11 · check-in free text available
-
2021-10-12
Health check-in — day 7, dose 3Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-10-19
Survey response — day 14, dose 3MedDRA: Diarrhoea — Feeling: GoodFree text: DiarrheaMedDRA releases: 2024-11 · check-in free text available
-
2021-10-26
Survey response — day 21, dose 3MedDRA: Back pain, Ear pain, Fatigue, Headache, Neck pain, Spinal pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Headache, spinal aching (neck and low back), ear ache, fatigue since receiving flu shot 10/22/21MedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
- 2021-11-11
- 2021-11-16
-
2022-01-04
Survey response — 3 months, dose 3MedDRA: Herpes zoster — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Shingles 11/23/21MedDRA releases: 2024-11 · check-in free text available
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2022-01-04
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-06
- 2022-04-05
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2022-04-08
Dose 4 — Moderna
- 2022-04-15
- 2022-04-22
- 2022-04-29
- 2022-05-06
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2022-05-13
Survey response — day 35, dose 4MedDRA: Decreased appetite, Diarrhoea, Fatigue, Headache, Pyrexia, Respiratory symptom — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Upper respiratory symptoms, low grade fever, fatigue, Diarrhea, lack of appetite, HA, low grade fever after travel to (b)(6); symptoms off and on for 12 days; 2 negative antigen tests, 2 negative NAAT tests over the course of illness.MedDRA releases: 2024-11 · check-in free text available
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2022-05-20
Survey response — day 42, dose 4MedDRA: Diarrhoea, Fatigue, Gastrointestinal disorder, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activitiesFree text: GI issues again, cramping and loose stool; fatigueMedDRA releases: 2024-11 · check-in free text available
- 2022-07-08
- 2022-10-07
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2023-04-08
Survey response — 12 months, dose 4MedDRA: Hyperkalaemia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
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2023-04-08
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-04-11
- 2023-04-11
-
2023-04-11
Callback requested for03:30PM ET
-
2023-04-11
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-04-11
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Pfizer-BioNTech | |
| 2 | 2021-02-04 | Pfizer-BioNTech | |
| 3 | 2021-10-05 | Pfizer-BioNTech | No |
| 4 | 2022-04-08 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): General malaise
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Allergy Symptoms- likely due to weather
Release 10 — day 14, dose 3
Symptoms: Diarrhea
Release 10 — day 21, dose 3
Symptoms: Headache, spinal aching (neck and low back), ear ache, fatigue since receiving flu shot 10/22/21
Release 10 — 3 months, dose 3
Symptoms: Shingles 11/23/21
Release 11 — day 35, dose 4
Symptoms: Upper respiratory symptoms, low grade fever, fatigue, Diarrhea, lack of appetite, HA, low grade fever after travel to (b)(6); symptoms off and on for 12 days; 2 negative antigen tests, 2 negative NAAT tests over the course of illness.
redacted (b)(6)
Release 11 — day 42, dose 4
Symptoms: GI issues again, cramping and loose stool; fatigue
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 | Decreased appetite | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Hyperkalaemia | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | Spinal pain | · | · | ✓ |
| SRO | Allergic respiratory symptom | · | · | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release