6PM-15818-10389

3 vaccinations 16 coded responses 31 check-ins 16 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 840 / UT
Registered: 2021-05-21

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

2021-05-21
Registered in v-safe
2021-05-21
Dose 1 — Pfizer-BioNTech
2021-05-21
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-27
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Nasal congestion — Feeling: Fair

Free text: Stuffy nose, short breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Survey response — day 7, dose 1
MedDRA: Dyspnoea, Nasal congestion — Feeling: Fair

Free text: Stuffy nose, short breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-06-11
Dose 2 — Pfizer-BioNTech
2021-06-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-06-12
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Poor · Site: Pain · 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: Head fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-13
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Sharp pains in areas of soreness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Nausea

Adult check-in
2021-06-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-06-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-06-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-06
Survey response — day 21, dose 2
MedDRA: Condition aggravated, Migraine, Post herpetic neuralgia, Pre-existing disease — Feeling: Fair · Be unable to work or attend school

Free text: It seems my post herpetoc neuralgia pain has increased in the last week and a half, had a migraine today as well 7/6/2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-07-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-10
Survey response — 3 months, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to work or attend school

Free text: Really bad headaches

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Dose 3 — Pfizer-BioNTech
2022-01-07
Survey response — day 0, dose 3
MedDRA: Brain fog — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Head fog

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Head fog

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Ear pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain, Lymphadenopathy, Pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Ear pain, swollen lymph nodes appeared last night on my left side between my breast and armpit, it is painful to move on a moderate level

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — days 1–6 daily, dose 3
MedDRA: Ear discomfort, Head discomfort, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cloudy, ear and head pressure on a moderate level

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy, Mobility decreased, Office visit, Painful respiration — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hurts to breathe, still have swollen lymph nodes, went to doctor yesterday and he said all my issues was from the booster, still having a hard time moving my head

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-01-21
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Survey response — day 21, dose 3
MedDRA: Headache, Nausea, Neck pain, Rash, Sinus pain — Feeling: Fair

Free text: Right arm has a small rash, still have a sore neck, get bouts of nausea and head/sinus pain

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Survey response — day 28, dose 3
MedDRA: Conjunctivitis, Headache, Sinus congestion — 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

Free text: Headache And sinuses stuffy, have pink eye

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Report sent to call center — day 28, 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 · 1 call case(s)
2022-02-09
Call successful
Participant prefers to complete VAERS report online
2022-02-20
Survey response — day 42, dose 3
MedDRA: Chills, Eye movement disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, also my right eyeball doing side to side rapid movement.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-21	Pfizer-BioNTech
2	2021-06-11	Pfizer-BioNTech
3	2022-01-07	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — day 0, dose 1

2021-05-21

Systemic reaction (other): Dizzy

Release 8 — days 1–6 daily, dose 1

2021-05-27

Systemic reaction (other): Stuffy nose, short breath

Release 8 — day 7, dose 1

2021-05-28

Systemic reaction (other): Stuffy nose, short breath

Release 9 — days 1–6 daily, dose 2

2021-06-12

Systemic reaction (other): Head fog

2021-06-13

Systemic reaction (other): Sharp pains in areas of soreness

Release 9 — day 21, dose 2

2021-07-06

Symptoms: It seems my post herpetoc neuralgia pain has increased in the last week and a half, had a migraine today as well 7/6/2021

Release 9 — 3 months, dose 2

2021-09-10

Symptoms: Really bad headaches

Release 10 — day 0, dose 3

2022-01-07

Systemic reaction (other): Head fog

Release 10 — days 1–6 daily, dose 3

2022-01-08

Systemic reaction (other): Head fog

2022-01-09

Systemic reaction (other): Ear pain

2022-01-10

Systemic reaction (other): Ear pain, swollen lymph nodes appeared last night on my left side between my breast and armpit, it is painful to move on a moderate level

2022-01-11

Systemic reaction (other): Cloudy, ear and head pressure on a moderate level

2022-01-12

Systemic reaction (other): Hurts to breathe, still have swollen lymph nodes, went to doctor yesterday and he said all my issues was from the booster, still having a hard time moving my head

Release 11 — day 21, dose 3

2022-01-28

Symptoms: Right arm has a small rash, still have a sore neck, get bouts of nausea and head/sinus pain

Release 11 — day 28, dose 3

2022-02-07

Symptoms: Headache And sinuses stuffy, have pink eye

Release 11 — day 42, dose 3

2022-02-20

Symptoms: Chills, also my right eyeball doing side to side rapid movement.

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	Chills	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Conjunctivitis	·	·	✓
SD	Eye movement disorder	·	·	✓
SD	Headache	·	·	✓
SD	Migraine	✓	✓	✓
SD	Nausea	·	·	✓
SD	Neck pain	·	·	✓
SD	Post herpetic neuralgia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinus pain	·	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear discomfort	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Head discomfort	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Mobility decreased	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Office visit	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Painful respiration	·	·	✓
SRO	Unevaluable event	·	·	✓

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