4QJ-26086-99882

3 vaccinations 16 coded responses 32 check-ins 16 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 604 / IL
Registered: 2021-10-02

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-10-01
Dose 1 — Pfizer-BioNTech
2021-10-02
Registered in v-safe
2021-10-02
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate irregular, Hypoaesthesia, Paraesthesia, Unevaluable event — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Tingling and numbness in fingers, loud intense heart beat, hands, feet, toes and legs which occur inconsistently

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Survey response — days 1–6 daily, dose 1
MedDRA: Electric shock sensation, Paraesthesia — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: On and off Tingling (feels like jolts of electrostatic sometimes) in fingers, hands, toes, feet and legs

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Muscle spasms, Paraesthesia — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Free text: Muscle spasms, intermittent tingling and slight numbness

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Good · Site: Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Injection in left arm, but I got a rash on my right forearm

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-07
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Rash — Feeling: Good · Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Rash on left forearm, itching all over

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Survey response — day 7, dose 1
MedDRA: Chest discomfort — Feeling: Good

Free text: Momentary chest tightness

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-10-22
Dose 2 — Pfizer-BioNTech
2021-10-22
Survey response — day 0, dose 2
MedDRA: Abdominal pain, Dizziness, Hypoaesthesia, Paraesthesia, Pruritus — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Tingling sporadically and all over & some sporadic numbness (moderate), mild light headed ness, abdominal cramping (mild), itching

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Fatigue, Muscle spasms, Paraesthesia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Muscle spasms, very tired making it hard to function, weakness throughout body, tingling in extremities

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Muscle spasms, Paraesthesia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness/light headedness last night, SEVERE muscle spasms throughout my body last night, tingling in limbs and digits

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Feeling abnormal, Lymph node pain, Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Yesterday I had abdominal pain, left clavicle lymph node swollen and painful yesterday, today less swollen and no pain, feel a little spacey today, slight sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Malaise — Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea

Free text: Malaise, brain fogginess for several,

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-21
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Brain fog, Cough, Epistaxis, Fatigue, Headache, Increased viscosity of upper respiratory secretion, Myalgia, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I tested positive for Covid. Symptoms from December 27-January 13. I still have a cough and lots of thick mucous, yesterday I blew blood when blowing my nose. Head ache, joint pain, muscle aches, head and chest congestion, extreme fatigue, cough, fog

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-30
Dose 3 — Pfizer-BioNTech
2022-05-04
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Swollen lymph nodes (all symptom have decreased since peak of symptoms which was on May 1st)

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-21
Survey response — day 21, dose 3
MedDRA: Chest discomfort, Chest pain, Hypoaesthesia, Paraesthesia — Feeling: Fair

Free text: Chest pain discomfort and numbness and tingling in my left arm

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-06-11
Survey response — day 42, dose 3
MedDRA: Anxiety, Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Intense anxiety, joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-08-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-29
Survey response — 6 months, dose 3
MedDRA: Arrhythmia, Heart rate decreased, Heart rate increased, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Increased heart rate increases and decreases-arrhythmia · Healthcare visit (other): Heart monitor for 1 month

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call successful
Participant prefers to complete VAERS report online
2023-04-30
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-01	Pfizer-BioNTech	No
2	2021-10-22	Pfizer-BioNTech	No
3	2022-04-30	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-10-02

Systemic reaction (other): Tingling and numbness in fingers, loud intense heart beat, hands, feet, toes and legs which occur inconsistently

2021-10-03

Systemic reaction (other): On and off Tingling (feels like jolts of electrostatic sometimes) in fingers, hands, toes, feet and legs

2021-10-04

Systemic reaction (other): Muscle spasms, intermittent tingling and slight numbness

Release 10 — days 1–6 daily, dose 1

2021-10-05

Systemic reaction (other): Injection in left arm, but I got a rash on my right forearm

2021-10-07

Systemic reaction (other): Rash on left forearm, itching all over

Release 10 — day 7, dose 1

2021-10-08

Systemic reaction (other): Momentary chest tightness

Release 10 — day 0, dose 2

2021-10-22

Systemic reaction (other): Tingling sporadically and all over & some sporadic numbness (moderate), mild light headed ness, abdominal cramping (mild), itching

Release 10 — days 1–6 daily, dose 2

2021-10-23

Systemic reaction (other): Muscle spasms, very tired making it hard to function, weakness throughout body, tingling in extremities

2021-10-24

Systemic reaction (other): Dizziness/light headedness last night, SEVERE muscle spasms throughout my body last night, tingling in limbs and digits

2021-10-26

Systemic reaction (other): Yesterday I had abdominal pain, left clavicle lymph node swollen and painful yesterday, today less swollen and no pain, feel a little spacey today, slight sore throat

2021-10-28

Systemic reaction (other): Malaise, brain fogginess for several,

Release 11 — 3 months, dose 2

2022-01-21

Symptoms: I tested positive for Covid. Symptoms from December 27-January 13. I still have a cough and lots of thick mucous, yesterday I blew blood when blowing my nose. Head ache, joint pain, muscle aches, head and chest congestion, extreme fatigue, cough, fog cut off by CDC

Release 11 — days 1–6 daily, dose 3

2022-05-04

Systemic reaction (other): Swollen lymph nodes (all symptom have decreased since peak of symptoms which was on May 1st)

Release 11 — day 21, dose 3

2022-05-21

Symptoms: Chest pain discomfort and numbness and tingling in my left arm

Release 12 — day 42, dose 3

2022-06-11

Symptoms: Intense anxiety, joint pain

Release 12 — 6 months, dose 3

2022-10-29

Symptoms: Increased heart rate increases and decreases-arrhythmia

Healthcare visit (other): Heart monitor for 1 month

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	Anxiety	·	·	✓
SD	Arrhythmia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Brain fog	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate decreased	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Increased viscosity of upper respiratory secretion	·	·	✓
SD	Myalgia	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Electric shock sensation	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Feeling abnormal	·	·	✓
SRO	Heart rate irregular	·	·	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Malaise	·	·	✓
SRO	Muscle spasms	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Paraesthesia	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rash	·	·	✓
SRO	Unevaluable event	·	·	✓

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