6CW-96003-21033

5 vaccinations 7 coded responses 35 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 856 / AZ
Registered: 2021-03-16

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-15
Dose 1 — Pfizer-BioNTech
2021-03-16
Registered in v-safe
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity, Pre-existing disease — Feeling: Good · Site: Pain

Free text: All of the symptoms i had yesterday except the arm pain went away when i took extra cortisol. I am cortisol dependent. I only increased my cortisol by 7.5mg yesterday and that resolved almost everything.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Pfizer-BioNTech
2021-04-05
Survey response — day 0, dose 2
MedDRA: Self-medication, Throat tightness — Feeling: Fair · Site: Pain, Swelling · Headache, Nausea

Free text: Needed to use ventlin inhaler 2x 10 min post shot. Had to take 100mg benadryl to stop airways from continuing to constrict. Had to use ventolin another 2x before benadryl kicked in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe allergic reaction to the shot is under control now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling, Rash, Rash erythematous, Rash pruritic, Swelling — Feeling: Fair · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash started Thursday night. Is very itchy, red and swollen covering most of my legs and now lower back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Not quite as bad a rash today as it was yesterday thank heavens!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-12
Survey response — day 7, dose 2
MedDRA: Rash — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: Rash not as itchy today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2022-04-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-24
Dose 4 — Moderna
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains · Be unable to do your normal daily activities

Adult check-in
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-06-14
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-06-22
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-13
Dose 5 — Pfizer-BioNTech
2022-10-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains

Adult check-in
2022-10-19
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2022-11-10
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-17
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-01-12
Survey response — 3 months, dose 5
MedDRA: Sinus node dysfunction — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Pfizer-BioNTech
2	2021-04-05	Pfizer-BioNTech
3	2021-11-19	Moderna	No
4	2022-05-24	Moderna	No
5	2022-10-13	Pfizer-BioNTech	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): All of the symptoms i had yesterday except the arm pain went away when i took extra cortisol. I am cortisol dependent. I only increased my cortisol by 7.5mg yesterday and that resolved almost everything.

Release 6 — day 0, dose 2

2021-04-05

Systemic reaction (other): Needed to use ventlin inhaler 2x 10 min post shot. Had to take 100mg benadryl to stop airways from continuing to constrict. Had to use ventolin another 2x before benadryl kicked in.

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Severe allergic reaction to the shot is under control now

2021-04-09

Systemic reaction (other): Rash started Thursday night. Is very itchy, red and swollen covering most of my legs and now lower back.

2021-04-10

Systemic reaction (other): Not quite as bad a rash today as it was yesterday thank heavens!

Release 7 — day 7, dose 2

2021-04-12

Systemic reaction (other): Rash not as itchy today.

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
SD	Sinus node dysfunction	·	·	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Throat tightness	✓	✓	✓

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