3FM-14583-23915

2 vaccinations 9 coded responses 19 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 129 / NY
Registered: 2021-09-07

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

2021-09-06
Dose 1 — Pfizer-BioNTech
2021-09-07
Registered in v-safe
2021-09-07
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Poor · Site: Pain · Fever · 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: Arm and face numbness and tingling

MedDRA releases: 2024-11 · check-in free text available
2021-09-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-09-10
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-09-11
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Menstruation irregular, Paraesthesia — 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: Numbness and tingling in extremities I have also started my menstrual cycle 10 days early for the 1st time in my life

MedDRA releases: 2024-11 · check-in free text available
2021-09-13
Survey response — day 7, dose 1
MedDRA: Guillain-Barre syndrome — 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: Gillian barre syndrome

MedDRA releases: 2024-11 · check-in free text available
2021-09-20
Survey response — day 14, dose 1
MedDRA: Headache, Mobility decreased, Nasal congestion, Oropharyngeal pain, Pain in extremity, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache is constant More arm pain Restrictions in movement Stuffy runny nose sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Dose 2 — Pfizer-BioNTech
2021-09-23
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-24
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Office visit — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · 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: I have been in direct contact with my health care provider since my 1st vaccine severe reaction on 9/6 I misread the question I have seen my doctor and emailed back and forth every other day

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Report sent to call center — days 1–6 daily, 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

1 call case(s)
2021-09-25
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, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-26
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, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-27
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, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-28
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, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-29
Survey response — days 1–6 daily, dose 2
MedDRA: Alopecia — Feeling: Poor · Site: Pain · Fever · Chills, 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: Hair loss

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-09-30
Survey response — day 7, dose 2
MedDRA: Alopecia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Hair loss

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-10-14
Survey response — day 21, dose 2
MedDRA: Rash — 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

Free text: Rash on arms

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Report sent to call center — day 21, 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)
2021-10-22
Survey response — day 28, dose 2
MedDRA: Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — 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

Free text: Congested Sore throat Runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Report sent to call center — day 28, 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)
2021-10-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-28
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-11-04
Health check-in — day 42, dose 2
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-06	Pfizer-BioNTech	No
2	2021-09-23	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-07

Systemic reaction (other): Arm and face numbness and tingling

2021-09-11

Systemic reaction (other): Numbness and tingling in extremities I have also started my menstrual cycle 10 days early for the 1st time in my life

Release 9 — day 7, dose 1

2021-09-13

Systemic reaction (other): Gillian barre syndrome

Release 9 — day 14, dose 1

2021-09-20

Symptoms: Headache is constant More arm pain Restrictions in movement Stuffy runny nose sore throat

Release 9 — days 1–6 daily, dose 2

2021-09-24

Healthcare visit (other): I have been in direct contact with my health care provider since my 1st vaccine severe reaction on 9/6 I misread the question I have seen my doctor and emailed back and forth every other day

2021-09-29

Systemic reaction (other): Hair loss

Release 9 — day 7, dose 2

2021-09-30

Systemic reaction (other): Hair loss

Release 10 — day 21, dose 2

2021-10-14

Symptoms: Rash on arms

Release 10 — day 28, dose 2

2021-10-22

Symptoms: Congested Sore throat Runny nose

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	Adverse reaction	·	·	✓
HCVO	Office visit	·	·	✓
SD	Headache	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Alopecia	·	·	✓
SRO	Guillain-Barre syndrome	·	·	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Menstruation irregular	·	·	✓
SRO	Paraesthesia	·	·	✓

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