3PB-30815-91202

4 vaccinations 5 coded responses 36 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 853 / AZ
Registered: 2020-12-19

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

2020-12-17
Dose 1 — Pfizer-BioNTech
2020-12-19
Registered in v-safe
2020-12-19
Survey response — days 1–6 daily, dose 1
MedDRA: Contusion, Tenderness — Feeling: Good

Free text: Large bruise like mark under right arm (sore to touch). Vaccinated in left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-20
Survey response — days 1–6 daily, dose 1
MedDRA: Contusion, Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: swollen lymphnode under right arm (vaccinated in left). Assuming swollen lymphnode because of large bruise like spot under arm, painful to touch. Day 2 of this.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2020-12-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-07
Dose 2 — Pfizer-BioNTech
2021-01-07
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-08
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Dose 3 — Pfizer-BioNTech
2022-01-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-01-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-21
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous, Uterine dilation and curettage — Feeling: Good · 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: Miscarriage requiring d and c. Months after shot and booster so not related.

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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-22
Call 1 — Left Voicemail
2022-04-22
Call successful
Participant prefers to complete VAERS report online
2022-09-08
Dose 4 — Moderna
Co-administered: Flu
2022-09-10
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Chills, Headache, 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: Swollen lymphnode under arm injection was given in

MedDRA releases: 2024-11 · check-in free text available
2022-09-11
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node Under arm injection was given

MedDRA releases: 2024-11 · check-in free text available
2022-09-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-17
Health check-in — day 7, dose 4
Feeling: Good · Nausea

Adult check-in
2022-09-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-09-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-17	Pfizer-BioNTech
2	2021-01-07	Pfizer-BioNTech
3	2021-10-21	Pfizer-BioNTech	No
4	2022-09-08	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-01-08	priority 2/3
2022-04-21	Successful 2022-04-22	Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-19

Systemic reaction (other): Large bruise like mark under right arm (sore to touch). Vaccinated in left arm

2020-12-20

Systemic reaction (other): swollen lymphnode under right arm (vaccinated in left). Assuming swollen lymphnode because of large bruise like spot under arm, painful to touch. Day 2 of this.

Release 11 — 6 months, dose 3

2022-04-21

Symptoms: Miscarriage requiring d and c. Months after shot and booster so not related.

Release 12 — days 1–6 daily, dose 4

2022-09-10

Systemic reaction (other): Swollen lymphnode under arm injection was given in

2022-09-11

Systemic reaction (other): Swollen lymph node Under arm injection was given

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	Abortion spontaneous	·	·	✓
SD	Uterine dilation and curettage	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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