SBT-21464-35211

4 vaccinations 19 coded responses 32 check-ins 19 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 961 / CA
Registered: 2021-04-08

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

Registered dependents

H8A-66019-83347 Child or adolescent in my care · Male · 2021-11-11

ZRB-13596-92248 Child or adolescent in my care · Female · 2021-11-11

4SE-31442-73455 Child or adolescent in my care · Female · 2022-08-11

Timeline

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

2021-04-08
Registered in v-safe
2021-04-08
Dose 1 — Pfizer-BioNTech
2021-04-08
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Injection site pain — Feeling: Good · Site: Pain, Swelling

Free text: The injection site pain increased today but did not affect my activities. I was tired - but not abnormally / likely not related to the vaccine.

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

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Disorientation, Fatigue, Feeling abnormal, Illogical thinking, Poor quality sleep, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Ive been feeling foggy in the head & disorganized. This and the fatigue could be related to poor sleep & my ADHD.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-24
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Condition aggravated, Fatigue, Initial insomnia, Pre-existing disease, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: On several nights Ive woken from sleep and been half awake but not able to fully wake up or go back to sleep. Ive felt tired and my ADHD medication feels less effective. I currently have a stomachache. (Not sure of cause - gas? - or full effect

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Dose 2 — Pfizer-BioNTech
2021-04-29
Survey response — day 0, dose 2
MedDRA: Pre-existing disease — Feeling: Good

Free text: Felt carsickness on way to vaccination, took Dramamine. Feeling fine now (6 hours after immunization)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Middle insomnia, Pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Body just feels weird sometimes. Foot felt inflated for a bit. Woke up throughout the night. Random stabbing pains throughout body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Emotional disorder — Feeling: Good · Headache, Muscle or body aches, Abdominal pain

Free text: Intense sensations/emotions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Emotional disorder — Feeling: Good

Free text: Ive felt intense emotions over the past few days that have finally subsided a bit today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 14, dose 2
MedDRA: Insomnia, Middle insomnia, Polymenorrhoea — Feeling: Good

Free text: Woke up at 3 AM, couldnt sleep. Delayed report: last month my menstrual cycle was slightly shorter, starting 4/16 (8 days after my first shot - only 23 days). It varies a bit but average is 25-26 days. The following cycle was 26 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 28, dose 2
MedDRA: Insomnia, Pre-existing disease — Feeling: Fair

Free text: Insomnia. I doubt this was related to the vaccine. Im also experiencing some allergy symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Moderna
2021-11-03
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain — Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Mildly painful/tender lymph node just beneath my armpit on the side of the injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain — Feeling: Good · Site: Pain, Redness · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Painful, tender possibly swollen lymph nodes in and under my armpit only on the side where I received my injection.

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Survey response — day 7, dose 3
MedDRA: Fatigue, Ophthalmic migraine, Poor quality sleep, Pre-existing disease — Feeling: Good · Headache, Fatigue or tiredness

Free text: Fatigue is due to poor sleep last night. Today I had an ocular migraine, which I tend to get once lot twice a year.

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-03
Survey response — day 28, dose 3
MedDRA: Migraine, Pre-existing disease — Feeling: Good

Free text: I had a visual migraine (already reported), which is not abnormal, but on several days since then I've felt some symptoms similar to what I get with the visual migraines. Possible other causes include fatigue/inadequate sleep and dehydration.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-12
Dose 4 — Moderna
Co-administered: Flu
2022-09-12
Survey response — day 0, dose 4
MedDRA: Injection site erythema, Injection site reaction, Injection site swelling, Urticaria — Feeling: Good · Site: Pain, Redness, Swelling

Free text: There's a raised red welt at the site of the injection

MedDRA releases: 2024-11 · check-in free text available
2022-09-13
Survey response — days 1–6 daily, dose 4
MedDRA: Discomfort, Pain, Pruritus, Skin induration, Skin warm, Urticaria — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Hard welt, warm skin within a circular area of about 1.5 inches. Started about 8 hours after shot, and 24 hours later the area has doubled in size. Pain decreased, itching/discomfort increased

MedDRA releases: 2024-11 · check-in free text available
2022-09-14
Survey response — days 1–6 daily, dose 4
MedDRA: Feeling hot, Induration, Urticaria — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My welt is slightly bigger than yesterday. It is hard and warm to the touch. Roughly the same as 24 hours ago but slightly bigger.

MedDRA releases: 2024-11 · check-in free text available
2022-09-14
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-15
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-09-20
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-10-04
Survey response — day 21, dose 4
MedDRA: Erythema, Oropharyngeal pain, Pre-existing disease — Feeling: Good

Free text: Sore throat, likely allergies. The redness on my arm lasted around 10 days.

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Survey response — day 28, dose 4
MedDRA: Upper-airway cough syndrome — Feeling: Good

Free text: A bit of post nasal drip. Possibly allergies.

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Survey response — day 42, dose 4
MedDRA: Arthralgia, Back pain, Cough, Neck pain, Oropharyngeal pain, Upper-airway cough syndrome — Feeling: Fair

Free text: Post nasal drip / sore throat, light cough with light pain below my throat, joint pain, back and neck pain.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Pfizer-BioNTech
2	2021-04-29	Pfizer-BioNTech
3	2021-11-03	Moderna	No
4	2022-09-12	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-09-14	Successful 2022-09-15	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): The injection site pain increased today but did not affect my activities. I was tired - but not abnormally / likely not related to the vaccine.

2021-04-14

Systemic reaction (other): Ive been feeling foggy in the head & disorganized. This and the fatigue could be related to poor sleep & my ADHD.

Release 7 — day 14, dose 1

2021-04-24

Symptoms: On several nights Ive woken from sleep and been half awake but not able to fully wake up or go back to sleep. Ive felt tired and my ADHD medication feels less effective. I currently have a stomachache. (Not sure of cause - gas? - or full effect

Release 8 — day 0, dose 2

2021-04-29

Systemic reaction (other): Felt carsickness on way to vaccination, took Dramamine. Feeling fine now (6 hours after immunization)

Release 8 — days 1–6 daily, dose 2

2021-04-30

Systemic reaction (other): Body just feels weird sometimes. Foot felt inflated for a bit. Woke up throughout the night. Random stabbing pains throughout body.

2021-05-01

Systemic reaction (other): Intense sensations/emotions

2021-05-03

Systemic reaction (other): Ive felt intense emotions over the past few days that have finally subsided a bit today.

Release 8 — day 14, dose 2

2021-05-13

Symptoms: Woke up at 3 AM, couldnt sleep. Delayed report: last month my menstrual cycle was slightly shorter, starting 4/16 (8 days after my first shot - only 23 days). It varies a bit but average is 25-26 days. The following cycle was 26 days.

Release 8 — day 28, dose 2

2021-05-27

Symptoms: Insomnia. I doubt this was related to the vaccine. Im also experiencing some allergy symptoms.

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): Mildly painful/tender lymph node just beneath my armpit on the side of the injection site

2021-11-05

Systemic reaction (other): Painful, tender possibly swollen lymph nodes in and under my armpit only on the side where I received my injection.

Release 10 — day 7, dose 3

2021-11-10

Systemic reaction (other): Fatigue is due to poor sleep last night. Today I had an ocular migraine, which I tend to get once lot twice a year.

Release 10 — day 28, dose 3

2021-12-03

Symptoms: I had a visual migraine (already reported), which is not abnormal, but on several days since then I've felt some symptoms similar to what I get with the visual migraines. Possible other causes include fatigue/inadequate sleep and dehydration.

Release 12 — day 0, dose 4

2022-09-12

Systemic reaction (other): There's a raised red welt at the site of the injection

Release 12 — days 1–6 daily, dose 4

2022-09-13

Systemic reaction (other): Hard welt, warm skin within a circular area of about 1.5 inches. Started about 8 hours after shot, and 24 hours later the area has doubled in size. Pain decreased, itching/discomfort increased

2022-09-14

Systemic reaction (other): My welt is slightly bigger than yesterday. It is hard and warm to the touch. Roughly the same as 24 hours ago but slightly bigger.

Release 12 — day 21, dose 4

2022-10-04

Symptoms: Sore throat, likely allergies. The redness on my arm lasted around 10 days.

Release 12 — day 28, dose 4

2022-10-16

Symptoms: A bit of post nasal drip. Possibly allergies.

Release 12 — day 42, dose 4

2022-10-30

Symptoms: Post nasal drip / sore throat, light cough with light pain below my throat, joint pain, back and neck pain.

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	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	Erythema	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Initial insomnia	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Middle insomnia	✓	✓	✓
SD	Migraine	·	·	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Polymenorrhoea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Disorientation	✓	·	✓
SRO	Emotional disorder	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling hot	·	·	✓
SRO	Illogical thinking	○	✓	○
SRO	Induration	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site reaction	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Ophthalmic migraine	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Skin induration	·	·	✓
SRO	Skin warm	·	·	✓
SRO	Urticaria	·	·	✓

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