5Z5-17004-50509

3 vaccinations 8 coded responses 30 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 490 / MI
Registered: 2021-01-20

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

2021-01-20
Registered in v-safe
2021-01-20
Dose 1 — Pfizer-BioNTech
2021-01-20
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good · Headache

Free text: My arm is slightly achey. Only near shot area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Parosmia — Feeling: Fair · Headache, Joint pains, Muscle or body aches

Free text: Not sure if this has anything to do with shot but I keep smelling smoke. I know...weird.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Pfizer-BioNTech
2021-02-10
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Its only been 4 hours since I had it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 35, dose 2
MedDRA: Anxiety, Asthma, Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My asthma seems to be kicking up. Its Spring so thats a possibility. Worse in the morning. Im also having very high anxiety lately. That tends to worsen my asthma. Dr appointment tomorrow. · Healthcare visit (other): Appointment is tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Survey response — 3 months, dose 2
MedDRA: Breast cancer, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have breast cancer now. · Healthcare visit (other): Numerous tests and consultations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-11
Survey response — 6 months, dose 2
MedDRA: Adverse reaction, Axillary lymphadenectomy, Breast cancer, Breast conserving surgery, Office visit, Radiotherapy, Surgery, Telemedicine — 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 visit

Free text: Symptoms: Breast cancer diagnosed in April. Lumpectomy done in June and lymph node removal too. Lymph nodes negative. Radiation therapy completed last week. · Healthcare visit (other): So many numerous tests and appointments required for this condition I have had hospital out patient surgery and in person visits along with video appointments.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-11
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call 1 — Left Voicemail
2021-08-13
Call successful
Participant prefers to complete VAERS report online
2021-09-24
Dose 3 — Pfizer-BioNTech
2021-09-30
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in extremity, Phlebitis superficial, Pre-existing disease, Ultrasound scan abnormal — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I just had ultrasound because they thought I had blood clots. Turned out to be superficial phlebitis. Pretty painful. Right leg above knee. Some of my symptoms above are because Ive started new meds in the past week for my breast cancer treatment.

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-15
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-22
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-10-29
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-07
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-25
Survey response — 3 months, dose 3
MedDRA: Headache, Migraine, Thrombectomy, Thrombosis — Feeling: Good · 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: Had a blood clot (superficial) removed from leg. Had my vaccine. 3rd one. Many headaches. It's all being dealt with. Migraine type stuff.

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-27
Call 1 — Left Voicemail
2022-03-25
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Pfizer-BioNTech
2	2021-02-10	Pfizer-BioNTech
3	2021-09-24	Pfizer-BioNTech	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-20

Systemic reaction (other): My arm is slightly achey. Only near shot area.

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): Not sure if this has anything to do with shot but I keep smelling smoke. I know...weird.

Release 4 — day 0, dose 2

2021-02-10

Systemic reaction (other): Its only been 4 hours since I had it.

Release 5 — day 35, dose 2

2021-03-18

Symptoms: My asthma seems to be kicking up. Its Spring so thats a possibility. Worse in the morning. Im also having very high anxiety lately. That tends to worsen my asthma. Dr appointment tomorrow.

Healthcare visit (other): Appointment is tomorrow

Release 8 — 3 months, dose 2

2021-05-12

Symptoms: I have breast cancer now.

Healthcare visit (other): Numerous tests and consultations

Release 9 — 6 months, dose 2

2021-08-11

Symptoms: Breast cancer diagnosed in April. Lumpectomy done in June and lymph node removal too. Lymph nodes negative. Radiation therapy completed last week.

Healthcare visit (other): So many numerous tests and appointments required for this condition I have had hospital out patient surgery and in person visits along with video appointments.

Release 9 — days 1–6 daily, dose 3

2021-09-30

Systemic reaction (other): I just had ultrasound because they thought I had blood clots. Turned out to be superficial phlebitis. Pretty painful. Right leg above knee. Some of my symptoms above are because Ive started new meds in the past week for my breast cancer treatment. cut off by CDC

Release 10 — 3 months, dose 3

2021-12-25

Symptoms: Had a blood clot (superficial) removed from leg. Had my vaccine. 3rd one. Many headaches. It's all being dealt with. Migraine type stuff.

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	Adverse reaction	✓	·	✓
HCVO	Office visit	✓	·	✓
HCVO	Surgery	✓	·	✓
HCVO	Telemedicine	✓	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Axillary lymphadenectomy	✓	·	✓
SD	Breast cancer	✓	✓	✓
SD	Breast conserving surgery	✓	·	✓
SD	Headache	·	·	✓
SD	Migraine	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Radiotherapy	✓	·	✓
SD	Thrombectomy	·	·	✓
SD	Thrombosis	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Phlebitis superficial	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Ultrasound scan abnormal	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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