4HC-27586-17527

3 vaccinations 6 coded responses 28 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 605 / IL
Registered: 2021-01-10

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Registered dependents

GLT-11427-10696 Child or adolescent in my care · Male · 2021-11-19

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-19
Dose 1 — Pfizer-BioNTech
2021-01-10
Registered in v-safe
2021-01-10
Dose 2 — Pfizer-BioNTech
2021-01-10
Survey response — day 0, dose 2
MedDRA: Paraesthesia oral — Feeling: Fair · Headache

Free text: Slight tingling in lips similar to when there is a lot of cottonwood floating in the air during my spring allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain

Free text: Pain was not at injection site, but lower-- midway b/w elbow and inj site. Occured 1 hour after initial check-in and lasted until midday today, 01/11/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Pain, Pyrexia, Self-medication — Feeling: Good · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: About 1 hour after my last check, I started getting aches, then fever, then chills. I woke up from a three hour nap at 2200 and chills and aches were gone, but fever was still present. I took 200 mg ibuprofen. When I awoke at 0700 today, 1/12/21, all symptoms were gone. Feeling good now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: I feel a little pain at injection site only when I press on it. Otherwise, I don't even notice it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Dose 3 — Pfizer-BioNTech
2021-11-19
Survey response — days 1–6 daily, dose 3
MedDRA: Immediate post-injection reaction, Injection site pain, Pain, Pain in extremity, Paraesthesia — Feeling: Good · Site: Pain, Redness

Free text: On 11.17.21 1-3 min post injection, I felt tingling all through arm down to fingertips. By 1800, arm in pain, especially when moving it. On 11.18.21 0600, woke up with no pain except when touching site.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-24
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-16
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-18
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-17
Survey response — 12 months, dose 3
MedDRA: Asthenia, Bronchitis, COVID-19, Chest pain, Cough, Oropharyngeal pain, Pulmonary pain, Self-medication — 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 · Telehealth, virtual health, or email health consultation

Free text: I had COVID. Symptoms: Pain in chest (bronchial tubes/lungs) on onset, sore throat, severe sore throat 2 days later, coughing, general lack of energy, bronchitis. Not sure if i had fever because I was taking ibuprofen for another reason at the time

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-19	Pfizer-BioNTech
2	2021-01-10	Pfizer-BioNTech
3	2021-11-17	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-12	priority 2/3
2022-11-17	Unsuccessful

Free text

Release 1 — day 0, dose 2

2021-01-10

Systemic reaction (other): Slight tingling in lips similar to when there is a lot of cottonwood floating in the air during my spring allergies.

Release 1 — days 1–6 daily, dose 2

2021-01-11

Systemic reaction (other): Pain was not at injection site, but lower-- midway b/w elbow and inj site. Occured 1 hour after initial check-in and lasted until midday today, 01/11/21.

2021-01-12

Systemic reaction (other): About 1 hour after my last check, I started getting aches, then fever, then chills. I woke up from a three hour nap at 2200 and chills and aches were gone, but fever was still present. I took 200 mg ibuprofen. When I awoke at 0700 today, 1/12/21, all symptoms were gone. Feeling good now.

2021-01-13

Systemic reaction (other): I feel a little pain at injection site only when I press on it. Otherwise, I don't even notice it.

Release 10 — days 1–6 daily, dose 3

2021-11-19

Systemic reaction (other): On 11.17.21 1-3 min post injection, I felt tingling all through arm down to fingertips. By 1800, arm in pain, especially when moving it. On 11.18.21 0600, woke up with no pain except when touching site.

Release 12 — 12 months, dose 3

2022-11-17

Symptoms: I had COVID. Symptoms: Pain in chest (bronchial tubes/lungs) on onset, sore throat, severe sore throat 2 days later, coughing, general lack of energy, bronchitis. Not sure if i had fever because I was taking ibuprofen for another reason at the time cut off by CDC

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	Asthenia	·	·	✓
SD	Bronchitis	·	·	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pulmonary pain	·	·	✓
SD	Self-medication	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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