5UX-90915-74465

4 vaccinations 14 coded responses 41 check-ins 14 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 030 / NH
Registered: 2021-03-15

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-13
Dose 1 — Pfizer-BioNTech
2021-03-15
Registered in v-safe
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Itching · Fever · Headache, Joint pains

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Seizure — Feeling: Good

Free text: Seizure this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increased headaches, nausea, diarrhea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Pfizer-BioNTech
2021-04-10
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — day 42, dose 2
MedDRA: Chills, Hyperhidrosis, Medical counselling, Pyrexia, Rash — 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

Free text: Symptoms: Rash, sweats, chills, fever · Healthcare visit (other): Labs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Myalgia, Pyrexia, Rash, Specialist consultation — Feeling: Fair · 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: Rash, fever, muscle pain, extreme fatigue, bruising. · Healthcare visit (other): Rheumatology

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-16
Call successful
Participant prefers to complete VAERS report online
2021-10-01
Dose 3 — Pfizer-BioNTech
2021-10-10
Health check-in — day 7, dose 3
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-15
Survey response — day 14, dose 3
MedDRA: Chills, Myalgia, Pyrexia, Rash — Feeling: Fair

Free text: Low grade fever, muscle ache, rash, chills ongoing. Muscle pain has increased.

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-30
Survey response — day 28, dose 3
MedDRA: Dyspnoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Increased SOB

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-04
Call successful
Does not wish to fill out VAERS report
2021-11-05
Survey response — day 35, dose 3
MedDRA: Dyspnoea — Feeling: Fair

Free text: Continued sob

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Survey response — day 42, dose 3
MedDRA: Dyspnoea, Productive cough — Feeling: Poor

Free text: Increased SOB, productive cough

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Survey response — 3 months, dose 3
MedDRA: Atelectasis, Pulmonary mass, Unevaluable event — Feeling: Poor · 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 visit

Free text: Symptoms: Nodule upper right lobe and atelectasis lower left lobe, son. · Healthcare visit (other): Seeing pulmonary this week

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Report sent to call center — 3 months, dose 3
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 visit · 1 call case(s)
2022-01-04
Call successful
Participant prefers to complete VAERS report online
2022-04-01
Survey response — 6 months, dose 3
MedDRA: Immune system disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increased immune problems

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Dose 4 — Pfizer-BioNTech
2022-05-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2022-05-19
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Swollen lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Survey response — day 7, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Swollen lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Survey response — day 14, dose 4
MedDRA: Arthralgia, Body temperature increased, Joint swelling, Lymphadenopathy, Nausea, Rash — Feeling: Poor

Free text: Increased nausea, sore and swollen joints, low temp, continued swollen lymph nodes, stomach rash

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-24
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-12
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-11
Survey response — 6 months, dose 4
MedDRA: Chills, Headache, Pre-existing disease, Unevaluable event — Feeling: Poor · 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: Right sided abd pain, nausea. Had bivalvent vaccine this afternoon despite abd pain. Having chills, increased nausea and headache since vaccine. · Healthcare visit (other): Multiple tests

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-14
Call successful
Participant prefers to complete VAERS report online
2023-05-13
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Pfizer-BioNTech
2	2021-04-10	Pfizer-BioNTech
3	2021-10-01	Pfizer-BioNTech	No
4	2022-05-13	Pfizer-BioNTech	No

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Seizure this morning

Release 6 — day 14, dose 1

2021-03-27

Symptoms: Increased headaches, nausea, diarrhea.

Release 8 — day 42, dose 2

2021-05-22

Symptoms: Rash, sweats, chills, fever

Healthcare visit (other): Labs

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Rash, fever, muscle pain, extreme fatigue, bruising.

Healthcare visit (other): Rheumatology

Release 10 — day 14, dose 3

2021-10-15

Symptoms: Low grade fever, muscle ache, rash, chills ongoing. Muscle pain has increased.

Release 10 — day 28, dose 3

2021-10-30

Symptoms: Increased SOB

Release 10 — day 35, dose 3

2021-11-05

Symptoms: Continued sob

Release 10 — day 42, dose 3

2021-11-12

Symptoms: Increased SOB, productive cough

Release 10 — 3 months, dose 3

2021-12-31

Symptoms: Nodule upper right lobe and atelectasis lower left lobe, son.

Healthcare visit (other): Seeing pulmonary this week

Release 11 — 6 months, dose 3

2022-04-01

Symptoms: Increased immune problems

Release 11 — days 1–6 daily, dose 4

2022-05-19

Systemic reaction (other): Swollen lymph nodes

Release 11 — day 7, dose 4

2022-05-20

Systemic reaction (other): Swollen lymph nodes

Release 11 — day 14, dose 4

2022-05-27

Symptoms: Increased nausea, sore and swollen joints, low temp, continued swollen lymph nodes, stomach rash

Release 12 — 6 months, dose 4

2022-11-11

Symptoms: Right sided abd pain, nausea. Had bivalvent vaccine this afternoon despite abd pain. Having chills, increased nausea and headache since vaccine.

Healthcare visit (other): Multiple tests

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	Specialist consultation	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Atelectasis	·	·	✓
SD	Body temperature increased	·	·	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Immune system disorder	·	·	✓
SD	Joint swelling	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Pulmonary mass	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Seizure	✓	✓	✓

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