3GW-11938-38669

2 vaccinations 7 coded responses 24 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 074 / NJ
Registered: 2021-04-06

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to work

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-22
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-04
Dose 2 — Pfizer-BioNTech
2021-05-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash erythematous — Feeling: Good · Site: Pain · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: I had red bumps appear on my arm 2 weeks after the 1st vaccine but didnt put together that they were from the vaccine. They are strange and werent going away. I now have more of them, on my hand too. The ones that appeared after the first have visibly changed since the second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-11
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — day 21, dose 2
MedDRA: Nodule — Feeling: Good

Free text: A few more Covid bumps on my face near the hairline

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 28, dose 2
MedDRA: Rash — Feeling: Good

Free text: My Covid rash made of raised bumps and other singular raised bumps continue to change color and composition (oozy, scabby) but do not go away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — day 35, dose 2
MedDRA: Skin discolouration — Feeling: Good

Free text: More covid dots. Othet dots continue to change in appearance and color

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Survey response — day 42, dose 2
MedDRA: Immunisation reaction, Pre-existing disease — Feeling: Fair · 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

Free text: Iron Deficiency Anemia, more Covid dots on right shoulder, Covid Dots continue to change in color and appearance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — day 42, 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)
2021-06-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-03
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-04
Survey response — 12 months, dose 2
MedDRA: Iron deficiency anaemia, Vitamin D deficiency — 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: Low iron anemia Vitamin D deficiency

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-05
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Pfizer-BioNTech
2	2021-05-04	Pfizer-BioNTech

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-05

Systemic reaction (other): I had red bumps appear on my arm 2 weeks after the 1st vaccine but didnt put together that they were from the vaccine. They are strange and werent going away. I now have more of them, on my hand too. The ones that appeared after the first have visibly changed since the second shot.

2021-05-06

Systemic reaction (other): insomnia

Release 8 — day 21, dose 2

2021-05-25

Symptoms: A few more Covid bumps on my face near the hairline

Release 8 — day 28, dose 2

2021-06-03

Symptoms: My Covid rash made of raised bumps and other singular raised bumps continue to change color and composition (oozy, scabby) but do not go away.

Release 8 — day 35, dose 2

2021-06-08

Symptoms: More covid dots. Othet dots continue to change in appearance and color

Release 9 — day 42, dose 2

2021-06-15

Symptoms: Iron Deficiency Anemia, more Covid dots on right shoulder, Covid Dots continue to change in color and appearance

Release 11 — 12 months, dose 2

2022-05-04

Symptoms: Low iron anemia Vitamin D deficiency

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	Immunisation reaction	✓	✓	✓
SD	Iron deficiency anaemia	·	·	✓
SD	Nodule	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Skin discolouration	✓	✓	✓
SD	Vitamin D deficiency	·	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓

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