4MW-17916-22431

3 vaccinations 14 coded responses 23 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 103 / NY
Registered: 2021-01-19

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Pfizer-BioNTech
2021-01-19
Survey response — day 0, dose 1
MedDRA: Myalgia, Pain in extremity — Feeling: Good · Site: Pain

Free text: Muscle pain down inj arm to wrist which subsided after an hour

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Dizziness, Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very tired no energy and dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Very tired after light activity have to lie down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-02-09
Dose 2 — Pfizer-BioNTech
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness imbalance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
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
2021-02-16
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Survey response — day 14, dose 2
MedDRA: Ear pain, Eye pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ear & Eye pain in both ears and eyes on snd off

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — day 21, dose 2
MedDRA: Cervical spinal stenosis, Musculoskeletal stiffness, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I had cervical spine fusion 7 years ago c2-t3and I feel a very pronounced stiffness and pulling sensation in my neck that was not as pronounced as it is after the second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 28, dose 2
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair

Free text: Tingling and numbness in lt foot leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 35, dose 2
MedDRA: Vein disorder — Feeling: Fair

Free text: A thick heavy vein popped out behind my lt knee which is painful to the touch I do not know if it could be related to the vaccine but I do not think it was not there before I had the vaccines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — 3 months, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good · Be unable to do your normal daily activities

Free text: Alot of stiffness all over muscles and boned

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Balance disorder, Dizziness, Gait disturbance, Office visit, Vestibular disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Imbalance unsteadiness when walking, dizzy spells but not vertigo. I was tested it is not the ear vestibular system, so I am going to vestibular rehab. · Healthcare visit (other): ENT specialust

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
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)
2021-08-15
Dose 3 — Pfizer-BioNTech
2021-08-17
Call 1 — Left Voicemail
2021-09-30
Survey response — day 42, dose 3
MedDRA: Balance disorder, Dizziness, Office visit, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: IM currently undergoing balance and dizziness PT for dizzy spells and imbalance, it is not vertigo, came on suddenly after third vaccine · Healthcare visit (other): dr. visit ent, vestibular testing by audiologist

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-14
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Call 1 — Could Not Reach Participant
2021-12-15
Call 2 — Left Voicemail
2022-02-15
Survey response — 6 months, dose 3
MedDRA: Infection, Office visit, Peripheral swelling — Feeling: Poor · 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: Symptoms: Finger bump treated for infection 2 rounds keflex not resolvef · Healthcare visit (other): Dermatologist and now going to ortho onc at nyu

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
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)
2022-02-16
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Pfizer-BioNTech
2	2021-02-09	Pfizer-BioNTech
3	2021-08-15	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-19

Systemic reaction (other): Muscle pain down inj arm to wrist which subsided after an hour

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): No

2021-01-23

Systemic reaction (other): Very tired no energy and dizzy

2021-01-24

Systemic reaction (other): Very tired after light activity have to lie down

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Dizziness imbalance

2021-02-12

Systemic reaction (other): Dizziness

Release 4 — day 14, dose 2

2021-02-23

Symptoms: Ear & Eye pain in both ears and eyes on snd off

Release 4 — day 21, dose 2

2021-03-02

Symptoms: I had cervical spine fusion 7 years ago c2-t3and I feel a very pronounced stiffness and pulling sensation in my neck that was not as pronounced as it is after the second shot

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Tingling and numbness in lt foot leg

Release 5 — day 35, dose 2

2021-03-16

Symptoms: A thick heavy vein popped out behind my lt knee which is painful to the touch I do not know if it could be related to the vaccine but I do not think it was not there before I had the vaccines

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: Alot of stiffness all over muscles and boned

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Imbalance unsteadiness when walking, dizzy spells but not vertigo. I was tested it is not the ear vestibular system, so I am going to vestibular rehab.

Healthcare visit (other): ENT specialust

Release 9 — day 42, dose 3

2021-09-30

Symptoms: IM currently undergoing balance and dizziness PT for dizzy spells and imbalance, it is not vertigo, came on suddenly after third vaccine

Healthcare visit (other): dr. visit ent, vestibular testing by audiologist

Release 11 — 6 months, dose 3

2022-02-15

Symptoms: Finger bump treated for infection 2 rounds keflex not resolvef

Healthcare visit (other): Dermatologist and now going to ortho onc at nyu

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	Office visit	✓	·	✓
SD	Balance disorder	✓	·	✓
SD	Cervical spinal stenosis	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Ear pain	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Gait disturbance	✓	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Infection	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Peripheral swelling	·	·	✓
SD	Physiotherapy	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Vein disorder	✓	✓	✓
SD	Vestibular disorder	✓	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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