3TV-13053-85675

3 vaccinations 8 coded responses 27 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 982 / WA
Registered: 2021-02-12

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Pfizer-BioNTech
2021-02-12
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Abdominal pain · Be unable to do your normal daily activities

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

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-03
Dose 2 — Pfizer-BioNTech
2021-03-03
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: got shot 5 minutes ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: very fuzzy headed, not alert

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-10-05
Dose 3 — Pfizer-BioNTech
2021-10-06
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain, Tinnitus — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · 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: Tinnitus, Back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — days 1–6 daily, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-07
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Chills, Headache, 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, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dizzyness

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · 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

Adult check-in
2021-10-08
Report sent to call center — days 1–6 daily, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-10
Survey response — days 1–6 daily, dose 3
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Sweating

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 3
MedDRA: Memory impairment — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Memory issues

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Survey response — day 7, dose 3
MedDRA: Memory impairment — Feeling: Fair

Free text: My memory has gone from about an 8 on a scale with 10 excellent, to about a 4.

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Survey response — day 14, dose 3
MedDRA: Herpes zoster, Immunisation reaction, Rash — Feeling: Fair · 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: Shingles which started about 4 days after my weeklong rash as a reaction to the Pfizer booster on 10/5. So Pfizer shot on 10/5, then a rash until about 10/10 or 10/11 , then shingles started about 10/15. I started valacyclovir on 10/17.

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-20
Call 1 — Left Voicemail
2021-10-21
Call successful
Participant prefers to complete VAERS report online
2021-10-26
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Pfizer-BioNTech
2	2021-03-03	Pfizer-BioNTech
3	2021-10-05	Pfizer-BioNTech	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 5 — day 0, dose 2

2021-03-03

Systemic reaction (other): got shot 5 minutes ago

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): very fuzzy headed, not alert

Release 10 — days 1–6 daily, dose 3

2021-10-06

Systemic reaction (other): Tinnitus, Back pain

2021-10-07

Systemic reaction (other): Dizzyness

2021-10-10

Systemic reaction (other): Sweating

2021-10-11

Systemic reaction (other): Memory issues

Release 10 — day 7, dose 3

2021-10-13

Systemic reaction (other): My memory has gone from about an 8 on a scale with 10 excellent, to about a 4.

Release 10 — day 14, dose 3

2021-10-19

Symptoms: Shingles which started about 4 days after my weeklong rash as a reaction to the Pfizer booster on 10/5. So Pfizer shot on 10/5, then a rash until about 10/10 or 10/11 , then shingles started about 10/15. I started valacyclovir on 10/17.

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	Herpes zoster	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Rash	·	·	✓
SRO	Back pain	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Memory impairment	·	·	✓
SRO	Tinnitus	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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