5XJ-11935-37330

4 vaccinations 11 coded responses 22 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 046 / ME
Registered: 2021-04-11

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-12
Dose 1 — Pfizer-BioNTech
2021-04-09
Dose 2 — Pfizer-BioNTech
2021-04-11
Registered in v-safe
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea, Oesophageal pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Yesterday my symptoms were more severe and I also had nausea and esophageal pain when eating or drinking

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

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, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Survey response — day 14, dose 2
MedDRA: Gout, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have gout for the past 2 days in my right big toe, and Ive never had gout before. It seems to be getting better. I sent a note to my doctor about it but havent had a reply.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 21, dose 2
MedDRA: Injection site pain, Myalgia, Paraesthesia — Feeling: Good

Free text: Im experiencing some nerve-type tingling in my face which seems related to the back muscle pain I had. I also get periodic soreness at the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 28, dose 2
MedDRA: Breast tenderness, Injection site pain — Feeling: Good

Free text: Breast tenderness on same side as vaccine injection site; still having intermittent pain at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 35, dose 2
MedDRA: Breast tenderness, Injection site pain — Feeling: Good

Free text: Continued breast tenderness; occasional pain at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 42, dose 2
MedDRA: Breast tenderness, Injection site pain — Feeling: Good

Free text: Still having occasional soreness at injection site and breast tenderness (same side as injection the left side)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Survey response — 3 months, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: Intermittent arm pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Blood urine present — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Blood in urine maybe a kidney stone

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-08
Call 1 — Left Voicemail
2021-12-09
Dose 3 — Moderna
2022-04-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-09
Dose 4 — Moderna
2022-05-23
Survey response — day 14, dose 4
MedDRA: Office visit, Vaginal haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Unexplained light vaginal nleeding · Healthcare visit (other): 3 doctor visits in person

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-24
Call 1 — Left Voicemail
2022-05-24
Call successful
Does not wish to fill out VAERS report
2022-05-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-20
Survey response — day 42, dose 4
MedDRA: Back pain, Myalgia — Feeling: Good

Free text: Inner triceps ache in both arms, but mostly in the right arm; upper back ache, mostly right side. All vaccines and boosters were in left arm.

MedDRA releases: 2024-11 · check-in free text available
2022-08-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-07
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-09
Survey response — 12 months, dose 4
MedDRA: Sinusitis, Throat irritation — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Pfizer-BioNTech
2	2021-04-09	Pfizer-BioNTech
3	2021-12-09	Moderna	No
4	2022-05-09	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Yesterday my symptoms were more severe and I also had nausea and esophageal pain when eating or drinking

Release 7 — day 14, dose 2

2021-04-23

Symptoms: I have gout for the past 2 days in my right big toe, and Ive never had gout before. It seems to be getting better. I sent a note to my doctor about it but havent had a reply.

Release 8 — day 21, dose 2

2021-04-30

Symptoms: Im experiencing some nerve-type tingling in my face which seems related to the back muscle pain I had. I also get periodic soreness at the injection site.

Release 8 — day 28, dose 2

2021-05-07

Symptoms: Breast tenderness on same side as vaccine injection site; still having intermittent pain at injection site

Release 8 — day 35, dose 2

2021-05-14

Symptoms: Continued breast tenderness; occasional pain at injection site

Release 8 — day 42, dose 2

2021-05-21

Symptoms: Still having occasional soreness at injection site and breast tenderness (same side as injection the left side)

Release 9 — 3 months, dose 2

2021-07-09

Symptoms: Intermittent arm pain

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: Blood in urine maybe a kidney stone

Release 11 — day 14, dose 4

2022-05-23

Symptoms: Unexplained light vaginal nleeding

Healthcare visit (other): 3 doctor visits in person

Release 12 — day 42, dose 4

2022-06-20

Symptoms: Inner triceps ache in both arms, but mostly in the right arm; upper back ache, mostly right side. All vaccines and boosters were in left arm.

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	Office visit	·	·	✓
SD	Back pain	·	·	✓
SD	Blood urine present	·	·	✓
SD	Breast tenderness	✓	✓	✓
SD	Gout	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Throat irritation	·	·	✓
SD	Vaginal haemorrhage	·	·	✓
SRO	Nausea	✓	✓	✓
SRO	Oesophageal pain	✓	✓	✓

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