4R4-13439-58913

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 857 / AZ
Registered: 2021-03-31

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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Pfizer-BioNTech
2021-03-31
Survey response — day 0, dose 1
MedDRA: Tongue pruritus — Feeling: Good · Headache

Free text: Very slight tongue itch

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

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — day 7, dose 1
MedDRA: Gallbladder disorder — Feeling: Fair · Diarrhea

Free text: I have gallbladder issues. I dont think this is connected to the vaccine but the first episode most likely was related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Fair

Free text: Extreme fatigue does not seem to be getting better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Dose 2 — Pfizer-BioNTech
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity, Lip swelling, Swollen tongue — Feeling: Poor · Site: Pain · 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: Allergic reaction 3 hours after dose. Swollen lips and tongue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe pain/swelling in lymph nodes on injection side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymph nodes still very swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Swollen lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-29
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Survey response — 6 months, dose 2
MedDRA: Hypersensitivity, Office visit — 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 · Outpatient clinic or urgent care clinic visit

Free text: Unexplained, slowly increasing allergic reaction. Started on abdomen and moved to back. Treated at Urgent Care. Got shingrix vaccine in September.

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Report sent to call center — 6 months, dose 2
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)
2021-10-22
Call successful
Participant prefers to complete VAERS report online
2022-04-22
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Pfizer-BioNTech
2	2021-04-22	Pfizer-BioNTech

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-31

Systemic reaction (other): Very slight tongue itch

Release 7 — day 7, dose 1

2021-04-07

Systemic reaction (other): I have gallbladder issues. I dont think this is connected to the vaccine but the first episode most likely was related.

Release 7 — day 21, dose 1

2021-04-21

Symptoms: Extreme fatigue does not seem to be getting better.

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Allergic reaction 3 hours after dose. Swollen lips and tongue.

2021-04-24

Systemic reaction (other): Severe pain/swelling in lymph nodes on injection side

2021-04-25

Systemic reaction (other): Lymph nodes still very swollen

2021-04-26

Systemic reaction (other): Swollen lymph nodes

Release 10 — 6 months, dose 2

2021-10-21

Symptoms: Unexplained, slowly increasing allergic reaction. Started on abdomen and moved to back. Treated at Urgent Care. Got shingrix vaccine in September.

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	Fatigue	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Office visit	·	·	✓
SRO	Gallbladder disorder	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Swollen tongue	✓	✓	✓
SRO	Tongue pruritus	✓	✓	✓

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