6K9-32552-13518

3 vaccinations 19 coded responses 38 check-ins 19 free-text entries 10 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 532 / WI
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Pfizer-BioNTech
2021-02-05
Survey response — day 0, dose 1
MedDRA: Heart rate increased — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Rapid heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My normal body temperature runs around 96

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Chills, Headache, Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Muscle or body aches

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Not sure if related to vaccine #1. Have auto immune illnesses, too.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Immunisation reaction, Medical counselling, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Not sure if vaccine reaction or if vaccine kicked an auto immune flare. · Healthcare visit (other): Phone consult

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-12
Survey response — day 7, dose 1
MedDRA: Back pain, Swelling — Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Right mid-back swelling and pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — day 14, dose 1
Feeling: Poor

Adult check-in
2021-02-26
Dose 2 — Pfizer-BioNTech
2021-02-26
Survey response — day 0, dose 2
MedDRA: Medical counselling, Muscle spasms — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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: Systemic reaction (other): Terrific muscle spasm in right hip and upper thigh · Healthcare visit (other): Phone conversation with triage murse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 0, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations, Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I run very low normally for a temperature (about 96 degrees). So, I may have a bit of a temperature. Heart palpitations, too. Cannot wait for getting my body back to my normal. I have been compromised all of February, I believe because of the vaccine. I have auto immune illnesses.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches

Adult check-in
2021-03-12
Survey response — day 14, dose 2
MedDRA: Blepharitis, Ear disorder, Ear infection, Ear pain, Middle ear effusion, Office visit, Tympanic membrane perforation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Right ear eardrum tear-not much infection though. Clear fluid there, today. Intermittent right ear pain all of February 2021 with vaccine on 2/5/21 and 2/26/21. Also, blepharitis of right eye diagnosed 3/10/21. · Healthcare visit (other): Workplace Clinic for ear problem

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Chest discomfort, Dyspnoea, Headache, Musculoskeletal discomfort, Upper respiratory tract infection — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Upper respiratory illness -tight chest, tight back, short of breath, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-20
Call 1 — Could Not Reach Participant
2021-07-27
Call 2 — Could Not Reach Participant
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-01
Dose 3 — Pfizer-BioNTech
2021-10-02
Survey response — days 1–6 daily, dose 3
MedDRA: Headache, Vaccine positive rechallenge — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Headache is the worse part. The same as vaccine #2.

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-04
Survey response — days 1–6 daily, dose 3
MedDRA: Arthritis, Erythema — Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Red inflamed wrist joint on opposite arm

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Survey response — days 1–6 daily, dose 3
MedDRA: Arthritis, Erythema, Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Red, inflammed wrist joint · Healthcare visit (other): Just MyChart check-in

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-10-06
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Hyperhidrosis, Pain of skin, Unevaluable event — Feeling: Fair · Site: Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Hair follicle/scalp tenderness; periods of sweating and then chills; · Healthcare visit (other): Lab work to check white blood count

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-07
Call 1 — Left Voicemail
2021-10-08
Survey response — day 7, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have UCTD, an auto immune condition. The vaccine stimulates my immune system to produce my UCTD symptoms/flare

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Call 2 — Left Voicemail
2021-10-15
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-23
Survey response — day 21, dose 3
MedDRA: Abdominal pain, Back pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Abdominal and mid to low back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — day 28, dose 3
MedDRA: Asthenia, Myalgia, Neuralgia — 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: Very weak body, muscle and nerve pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Report sent to call center — day 28, 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 · 1 call case(s)
2021-11-03
Call 1 — Left Voicemail
2021-11-03
Call successful
Participant prefers to complete VAERS report online
2021-11-05
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-12
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-31
Survey response — 3 months, dose 3
MedDRA: Headache, Hypoaesthesia, Paraesthesia, Sacroiliitis — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Sacraliliits and on-going headaches since mid-October 2021. Started with tingling and numbness in my face and extremities in November.

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-01-05
Call 1 — Could Not Reach Participant
2022-01-10
Call 2 — Could Not Reach Participant
2022-04-01
Survey response — 6 months, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Daily congestion that is not allergies or a sinus infection. Internist, ENT, and allergist are all stumped. It has been going on since early January 2022.

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-05
Call 1 — Could Not Reach Participant
2022-04-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-01
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, 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: Got COVID in May 2022. Vaccines, boosters, and Paxlovid helped.

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Pfizer-BioNTech
2	2021-02-26	Pfizer-BioNTech
3	2021-10-01	Pfizer-BioNTech	No

Call center

10 call center cases

9 successful · 1 unsuccessful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-05

Systemic reaction (other): Rapid heart beat

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): My normal body temperature runs around 96

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Not sure if related to vaccine #1. Have auto immune illnesses, too.

2021-02-11

Systemic reaction (other): Not sure if vaccine reaction or if vaccine kicked an auto immune flare.

Healthcare visit (other): Phone consult

Release 4 — day 7, dose 1

2021-02-12

Systemic reaction (other): Right mid-back swelling and pain

Release 4 — day 0, dose 2

2021-02-26

Systemic reaction (other): Terrific muscle spasm in right hip and upper thigh

Healthcare visit (other): Phone conversation with triage murse

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): I run very low normally for a temperature (about 96 degrees). So, I may have a bit of a temperature. Heart palpitations, too. Cannot wait for getting my body back to my normal. I have been compromised all of February, I believe because of the vaccine. I have auto immune illnesses.

Release 5 — day 14, dose 2

2021-03-12

Symptoms: Right ear eardrum tear-not much infection though. Clear fluid there, today. Intermittent right ear pain all of February 2021 with vaccine on 2/5/21 and 2/26/21. Also, blepharitis of right eye diagnosed 3/10/21.

Healthcare visit (other): Workplace Clinic for ear problem

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Upper respiratory illness -tight chest, tight back, short of breath, headache

Release 9 — days 1–6 daily, dose 3

2021-10-02

Systemic reaction (other): Headache is the worse part. The same as vaccine #2.

2021-10-04

Systemic reaction (other): Red inflamed wrist joint on opposite arm

Release 10 — days 1–6 daily, dose 3

2021-10-05

Systemic reaction (other): Red, inflammed wrist joint

Healthcare visit (other): Just MyChart check-in

2021-10-06

Systemic reaction (other): Hair follicle/scalp tenderness; periods of sweating and then chills;

Healthcare visit (other): Lab work to check white blood count

Release 10 — day 7, dose 3

2021-10-08

Systemic reaction (other): I have UCTD, an auto immune condition. The vaccine stimulates my immune system to produce my UCTD symptoms/flare

Release 10 — day 21, dose 3

2021-10-23

Symptoms: Abdominal and mid to low back pain

Release 10 — day 28, dose 3

2021-10-30

Symptoms: Very weak body, muscle and nerve pain

Release 10 — 3 months, dose 3

2021-12-31

Symptoms: Sacraliliits and on-going headaches since mid-October 2021. Started with tingling and numbness in my face and extremities in November.

Release 11 — 6 months, dose 3

2022-04-01

Symptoms: Daily congestion that is not allergies or a sinus infection. Internist, ENT, and allergist are all stumped. It has been going on since early January 2022.

Release 12 — 12 months, dose 3

2022-10-01

Symptoms: Got COVID in May 2022. Vaccines, boosters, and Paxlovid helped.

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	Ear disorder	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal pain	·	·	✓
SD	Asthenia	·	·	✓
SD	Back pain	·	·	✓
SD	Blepharitis	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear infection	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Middle ear effusion	✓	✓	✓
SD	Musculoskeletal discomfort	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Neuralgia	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sacroiliitis	·	·	✓
SD	Tympanic membrane perforation	✓	✓	✓
SD	Upper respiratory tract infection	✓	✓	✓
SRO	Arthritis	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Erythema	·	·	✓
SRO	Headache	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pain of skin	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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