4MS-74634-71664

4 vaccinations 9 coded responses 26 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 503 / IA
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Pfizer-BioNTech
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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 · None

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

Adult check-in
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Survey response — day 14, dose 1
MedDRA: Colonoscopy, Rectal haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Rectal bleeding severe enough that my hemoglobin went from 14 to 7.4. The bleeding started suddenly at 5:00 pm on Monday, 7:22:21. I had a colonoscopy today & no cause was identified. I have no reason to think the rectal bleeding is related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Dose 2 — Pfizer-BioNTech
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

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

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

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

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 · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 2
Feeling: Fair · None

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Right hip pain. Severe aching in multiple joints.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Survey response — day 42, dose 2
MedDRA: Cholecystectomy, Cholelithiasis, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Had gallbladder removed today due to gallbladder stones. · Healthcare visit (other): Same day surgery. I am home now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-03
Survey response — 3 months, dose 2
MedDRA: Surgery — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gallbladder surgery · Healthcare visit (other): Same day surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-06-18
Callback requested for
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-08-28
Dose 3 — Pfizer-BioNTech
2021-09-02
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Pre-existing disease — Feeling: Poor · 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: New onset severe arthritic pain in both hands, arms, neck, feet. I also have a history of previous auto-immune disorders unrelated to any vaccine.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-02
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-07
Call successful
Does not wish to fill out VAERS report
2022-01-28
Dose 4 — Moderna
2022-03-04
Survey response — 12 months, dose 2
MedDRA: Asthma, Bone pain, Maxillofacial pain, Nasal discharge discolouration, Pre-existing disease, Sinusitis — Feeling: Good

Free text: Possible sinus infection with R ethmoid & maxillary face pain & copious thick green/brown drainage. But I have a lifetime history of sinus infections preceding asthma exacerbations. I'm OK now. It may have started before I received a 2nd booster.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Pfizer-BioNTech
2	2021-03-04	Pfizer-BioNTech
3	2021-08-28	Pfizer-BioNTech	No
4	2022-01-28	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): No

2021-02-13

Systemic reaction (other): No

Release 4 — day 14, dose 1

2021-02-25

Symptoms: Rectal bleeding severe enough that my hemoglobin went from 14 to 7.4. The bleeding started suddenly at 5:00 pm on Monday, 7:22:21. I had a colonoscopy today & no cause was identified. I have no reason to think the rectal bleeding is related.

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Sore throat

Release 6 — day 28, dose 2

2021-04-01

Symptoms: Right hip pain. Severe aching in multiple joints.

Release 7 — day 42, dose 2

2021-04-15

Symptoms: Had gallbladder removed today due to gallbladder stones.

Healthcare visit (other): Same day surgery. I am home now.

Release 8 — 3 months, dose 2

2021-06-03

Symptoms: Gallbladder surgery

Healthcare visit (other): Same day surgery

Release 9 — 6 months, dose 2

2021-09-02

Symptoms: New onset severe arthritic pain in both hands, arms, neck, feet. I also have a history of previous auto-immune disorders unrelated to any vaccine.

Release 11 — 12 months, dose 2

2022-03-04

Symptoms: Possible sinus infection with R ethmoid & maxillary face pain & copious thick green/brown drainage. But I have a lifetime history of sinus infections preceding asthma exacerbations. I'm OK now. It may have started before I received a 2nd booster.

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	Surgery	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Bone pain	·	·	✓
SD	Cholecystectomy	✓	✓	✓
SD	Cholelithiasis	✓	✓	✓
SD	Colonoscopy	✓	✓	✓
SD	Maxillofacial pain	·	·	✓
SD	Nasal discharge discolouration	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Rectal haemorrhage	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Surgery	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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