4MA-11329-58539

3 vaccinations 5 coded responses 29 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 970 / OR
Registered: 2021-04-14

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

2021-03-24
Dose 1 — Pfizer-BioNTech
2021-04-14
Registered in v-safe
2021-04-14
Dose 2 — Pfizer-BioNTech
2021-04-14
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Headache

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Fever · Chills, Headache

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Sciatica — Feeling: Good · Be unable to do your normal daily activities

Free text: I have had an increase in sciatic nerve pain that began shortly after the second vaccine dose, don't know if they are related, but it's been very painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 21, dose 2
MedDRA: Cough, Diarrhoea, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, diarrhea, light cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-16
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-16
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-10-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-18
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-10-21
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: **I got the 65+ flu shot at the same time. I do not recommend this to people with health conditions, especially those with fibrosis or fibromyalgia, people with autoimmune issues.

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · Headache

Adult check-in
2021-10-23
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-11-08
Survey response — day 21, dose 3
MedDRA: Injection site pain — Feeling: Fair

Free text: Pain in the muscle at injection site. Feels like nerve pain.

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-15
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Ear pain, Fatigue, Paranasal sinus discomfort, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Ear ache, sinus pressure, fatigue. Still some residual pain in left shoulder. · Healthcare visit (other): Will be talking with doctor shortly

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-18
Call 1 — Left Voicemail
2022-01-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-16
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-18
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Pfizer-BioNTech
2	2021-04-14	Pfizer-BioNTech
3	2021-10-16	Pfizer-BioNTech	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — day 14, dose 2

2021-04-28

Symptoms: I have had an increase in sciatic nerve pain that began shortly after the second vaccine dose, don't know if they are related, but it's been very painful.

Release 8 — day 21, dose 2

2021-05-07

Symptoms: Headache, diarrhea, light cough.

Release 10 — days 1–6 daily, dose 3

2021-10-21

Systemic reaction (other): **I got the 65+ flu shot at the same time. I do not recommend this to people with health conditions, especially those with fibrosis or fibromyalgia, people with autoimmune issues.

Release 10 — day 21, dose 3

2021-11-08

Symptoms: Pain in the muscle at injection site. Feels like nerve pain.

Release 10 — 3 months, dose 3

2022-01-15

Symptoms: Ear ache, sinus pressure, fatigue. Still some residual pain in left shoulder.

Healthcare visit (other): Will be talking with doctor shortly

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	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Sciatica	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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