4UC-21094-99255
4 vaccinations
11 coded responses
42 check-ins
11 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 958 / CA
- Registered
- 2021-02-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Registered in v-safe
-
2021-02-17
Dose 1 — Pfizer-BioNTech
- 2021-02-17
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Muscle or body achesFree text: Gleuteus Maximus muscles but not noticeable later in the dayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-26
- 2021-03-03
-
2021-03-10
Dose 2 — Pfizer-BioNTech
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Seasonal allergy, Sneezing — Feeling: GoodFree text: Sneezing & some occasional need to blow nose. Most likely hay fever with everything blooming right now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Rhinorrhoea, Seasonal allergy, Self-medication — Feeling: GoodFree text: Still have slightly drippy nose at times probably due to hay fever in spite of a daily claritinMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
-
2021-03-17
Survey response — day 7, dose 2MedDRA: Headache, Pre-existing disease — Feeling: Fair · HeadacheFree text: Slight headache off and on most of day but working on taxes right now and stressful. Also take 1300 mg Tylenol twice daily for osteoarthritis and R knee that is waiting for Total Knee ReplacementMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
-
2021-03-31
Survey response — day 21, dose 2MedDRA: Malaise, Nausea — Feeling: GoodFree text: Only slept 2 1/2 hrs last night and felt terrible this morning, also slightly nauseated. Able to get 1/2 bagel & 4 ounces OJ in plus regular morning meds after dressing. Then went and laid down for an hour & half. Felt ok after, back to reg activiMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-06-09
-
2021-09-08
Survey response — 6 months, dose 2MedDRA: Knee arthroplasty, Medical counselling, Osteoarthritis, Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Had a Total Right Knee Transplant 7-29-21 for severe osteoarthritis · Healthcare visit (other): Outpatient same day surgery followed up by home are for 3 weekdMedDRA releases: 2024-11 · check-in free text available
-
2021-09-08
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-13
-
2021-09-13
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-09-25
Dose 3 — Pfizer-BioNTech
-
2021-09-30
Survey response — days 1–6 daily, dose 3MedDRA: Erythema, Mobility decreased, Oral mucosal erythema, Oral pain, Pain in extremity, Palatal swelling, Peripheral swelling, Skin warm — Feeling: GoodFree text: Shot Sat morning, by Sat evening arm was very sore and could almost lift even elbow. Also as arm got sore, red, hot & a little swollen so did roof of my mouth which reacted same way and was very painful. Both took about 4 to 5 days to become normalMedDRA releases: 2024-11 · check-in free text available
- 2021-10-01
- 2021-10-02
- 2021-10-09
-
2021-10-16
Survey response — day 21, dose 3MedDRA: Intestinal haemorrhage, Knee arthroplasty, Post procedural haemorrhage, Self-medication — Feeling: FairFree text: Intestinal bleeding 2 mornings in a row due to daily post op baby aspirin plus restarting turmeric med 5 days ago(had R Total Knee Transplant 7/29/21 & baby aspirin order was fir 3 months to prevent clots). Stopped both meds and no further bleedingMedDRA releases: 2024-11 · check-in free text available
-
2021-10-24
Survey response — day 28, dose 3MedDRA: Atrial fibrillation, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Run of Afib per my Apple 6E watch a week ago Saturday. Primary Care Doctor had ekg done and I am now wearing 14 day Zio XT cardiac monitorMedDRA releases: 2024-11 · check-in free text available
-
2021-10-24
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-27
Call successfulParticipant prefers to complete VAERS report online
- 2021-10-30
- 2021-11-06
-
2021-12-25
Survey response — 3 months, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: GoodFree text: Had bilateral cataract surgeries about 2 years ago. Vision now becoming foggy due to cellular growth in both eyes. Scheduled for laser surgery to correct problem Feb 7.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-26
-
2022-04-02
Dose 4 — Pfizer-BioNTech
- 2022-04-14
- 2022-04-16
- 2022-04-23
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-07-02
-
2022-10-01
Survey response — 6 months, dose 4MedDRA: Foot operation, Nasopharyngitis, Throat irritation — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Have a bad cold which started with a scratchy throat on Wed Sept 28, first cold in years! Had arthroplasty L foot, toes 3 & 4 Tues Sept 27MedDRA releases: 2024-11 · check-in free text available
- 2023-04-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Pfizer-BioNTech | |
| 2 | 2021-03-10 | Pfizer-BioNTech | |
| 3 | 2021-09-25 | Pfizer-BioNTech | No |
| 4 | 2022-04-02 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Gleuteus Maximus muscles but not noticeable later in the day
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Sneezing & some occasional need to blow nose. Most likely hay fever with everything blooming right now.
Systemic reaction (other): Still have slightly drippy nose at times probably due to hay fever in spite of a daily claritin
Release 5 — day 7, dose 2
Systemic reaction (other): Slight headache off and on most of day but working on taxes right now and stressful. Also take 1300 mg Tylenol twice daily for osteoarthritis and R knee that is waiting for Total Knee Replacement
Release 6 — day 21, dose 2
Symptoms: Only slept 2 1/2 hrs last night and felt terrible this morning, also slightly nauseated. Able to get 1/2 bagel & 4 ounces OJ in plus regular morning meds after dressing. Then went and laid down for an hour & half. Felt ok after, back to reg activi cut off by CDC
Release 9 — 6 months, dose 2
Symptoms: Had a Total Right Knee Transplant 7-29-21 for severe osteoarthritis
Healthcare visit (other): Outpatient same day surgery followed up by home are for 3 weekd
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Shot Sat morning, by Sat evening arm was very sore and could almost lift even elbow. Also as arm got sore, red, hot & a little swollen so did roof of my mouth which reacted same way and was very painful. Both took about 4 to 5 days to become normal cut off by CDC
Release 10 — day 21, dose 3
Symptoms: Intestinal bleeding 2 mornings in a row due to daily post op baby aspirin plus restarting turmeric med 5 days ago(had R Total Knee Transplant 7/29/21 & baby aspirin order was fir 3 months to prevent clots). Stopped both meds and no further bleeding cut off by CDC
Release 10 — day 28, dose 3
Symptoms: Run of Afib per my Apple 6E watch a week ago Saturday. Primary Care Doctor had ekg done and I am now wearing 14 day Zio XT cardiac monitor
Release 10 — 3 months, dose 3
Symptoms: Had bilateral cataract surgeries about 2 years ago. Vision now becoming foggy due to cellular growth in both eyes. Scheduled for laser surgery to correct problem Feb 7.
Release 12 — 6 months, dose 4
Symptoms: Have a bad cold which started with a scratchy throat on Wed Sept 28, first cold in years! Had arthroplasty L foot, toes 3 & 4 Tues Sept 27
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 | Medical counselling | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Foot operation | · | · | ✓ |
| SD | Intestinal haemorrhage | · | · | ✓ |
| SD | Knee arthroplasty | · | · | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Osteoarthritis | · | · | ✓ |
| SD | Post procedural haemorrhage | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | · | · | ✓ |
| SRO | Oral mucosal erythema | · | · | ✓ |
| SRO | Oral pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Palatal swelling | · | · | ✓ |
| SRO | Peripheral swelling | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Seasonal allergy | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Skin warm | · | · | ✓ |
| SRO | Sneezing | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release