54A-23263-72014

3 vaccinations 12 coded responses 35 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 953 / CA
Registered: 2021-08-07

Relationship: Self
Race: Asian
Ethnicity: Hispanic or Latino

Timeline

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

2021-08-06
Dose 1 — Pfizer-BioNTech
2021-08-07
Registered in v-safe
2021-08-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-08-09
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersomnia — Feeling: Good

Free text: Sleeping 12 hours unusual for me.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-08-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-08-27
Dose 2 — Pfizer-BioNTech
2021-08-27
Health check-in — day 0, dose 2
Feeling: Good · Chills

Adult check-in
2021-08-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-09-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-09-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-09-10
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair

Free text: Headache fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-09-24
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-10-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-10-08
Survey response — day 42, dose 2
MedDRA: Injection site pain, Muscle spasms — Feeling: Fair

Free text: Spasms in left shoulder where I got shot. Pain and tenderness at shot site.

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — 3 months, dose 2
MedDRA: Muscle spasms, Pain in extremity, Vomiting — Feeling: Poor · Be unable to work or attend school

Free text: Vomiting, spasm in arm that was vaccinated and hand pain in vaccinated arm.

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Dose 3 — Pfizer-BioNTech
2022-01-27
Survey response — days 1–6 daily, dose 3
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Swelling

Free text: Tingling in legs

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Free text: Memory issue

MedDRA releases: 2024-11 · check-in free text available
2022-01-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fatigue or tiredness

Adult check-in
2022-01-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-02-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-02
Health check-in — day 7, dose 3
Feeling: Fair · None

Adult check-in
2022-02-09
Survey response — day 14, dose 3
MedDRA: Cough, Dizziness, Fatigue, Musculoskeletal pain, Oropharyngeal pain, Pain, Productive cough — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, sore throat, aches and pains, back shoulder blade pain, dizziness, phlegm, and extreme fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-02-23
Survey response — day 28, dose 3
MedDRA: Fatigue — Feeling: Fair

Free text: Exhausted

MedDRA releases: 2024-11 · check-in free text available
2022-03-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-09
Survey response — day 42, dose 3
MedDRA: Fatigue — Feeling: Fair

Free text: Extreme fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Survey response — 3 months, dose 3
MedDRA: Brain fog, Joint swelling, Memory impairment — Feeling: Fair

Free text: Swelling in joints, memory fog, can't remember things.

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Survey response — 6 months, dose 3
MedDRA: Brain fog, Fatigue, Myalgia — Feeling: Poor · Be unable to work or attend school

Free text: Exhausted, muscle aches, brain fog,

MedDRA releases: 2024-11 · check-in free text available
2023-01-29
Survey response — 12 months, dose 3
MedDRA: Cyst, Fatigue, Hypoaesthesia, Memory impairment, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-29
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-06	Pfizer-BioNTech	No
2	2021-08-27	Pfizer-BioNTech	No
3	2022-01-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2023-01-29	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-09

Systemic reaction (other): Sleeping 12 hours unusual for me.

Release 9 — day 14, dose 2

2021-09-10

Symptoms: Headache fatigue

Release 10 — day 42, dose 2

2021-10-08

Symptoms: Spasms in left shoulder where I got shot. Pain and tenderness at shot site.

Release 10 — 3 months, dose 2

2021-11-26

Symptoms: Vomiting, spasm in arm that was vaccinated and hand pain in vaccinated arm.

Release 11 — days 1–6 daily, dose 3

2022-01-27

Systemic reaction (other): Tingling in legs

2022-01-29

Systemic reaction (other): Memory issue

Release 11 — day 14, dose 3

2022-02-09

Symptoms: Cough, sore throat, aches and pains, back shoulder blade pain, dizziness, phlegm, and extreme fatigue.

Release 11 — day 28, dose 3

2022-02-23

Symptoms: Exhausted

Release 11 — day 42, dose 3

2022-03-09

Symptoms: Extreme fatigue

Release 11 — 3 months, dose 3

2022-04-27

Symptoms: Swelling in joints, memory fog, can't remember things.

Release 12 — 6 months, dose 3

2022-07-29

Symptoms: Exhausted, muscle aches, brain fog,

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	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	Cyst	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Injection site pain	·	·	✓
SD	Joint swelling	·	·	✓
SD	Memory impairment	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Musculoskeletal pain	·	·	✓
SD	Myalgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Productive cough	·	·	✓
SD	Vomiting	·	·	✓
SRO	Hypersomnia	✓	·	✓
SRO	Paraesthesia	·	·	✓
SRO	Unevaluable event	·	·	✓

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