Y28-29592-71673

3 vaccinations 7 coded responses 25 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 631 / MO
Registered: 2021-03-24

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

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Pfizer-BioNTech
2021-03-24
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Mild Pain @ Injection site early morning. Gone before 12pm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Pfizer-BioNTech
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy, Rash, Rash erythematous — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: I received the vaccine in my left arm. There is an area with a red rash under my left armpit. Additionally, the glands under that armpit are swollen and painful when palpitated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Palpitations, Rash, Rash erythematous — Feeling: Good · Site: Pain, Swelling · Rash, not including the immediate area around the injection site

Free text: Continuation of symptoms reported yesterday: swelling of glands, pain @ palpitation, and rash in the area beneath my left armpit. The symptoms, most notably the blotchy, red rash, have spread downward a bit since yesterday to the area between my left armpit and towards the top of my left breast area. I have taken photos each day as documentation to share if needed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Pain, Rash — Feeling: Good

Free text: Vaccine administered in left arm. Glands under left armpit are still moderately swollen. Rash and pain on palpitation are gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Injection was in left arm. Glands under left armpit are still moderately to slightly swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-09
Dose 3 — Pfizer-BioNTech
2022-04-15
Survey response — 12 months, dose 2
MedDRA: Alopecia areata — Feeling: Good

Free text: Alopecia Areata

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
Survey response — 6 months, dose 3
MedDRA: Alopecia areata, Condition aggravated, Office visit, Pre-existing disease, Reaction to previous exposure to any vaccine — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Alopecia: 1st small bald patch noticed in August 2021, several months after 2nd Pfizer COVID vaccination. Hair loss increased significantly after Pfizer Booster in Dec. '21, and continues daily 24/7/365. GP referral to Dermatology Specialist 6/28/22. · Healthcare visit (other): Initial diagnosis of Alopecia Areata made by my GP, Dr. (b)(6) . Dr. (b)(6) referral to Dermatology Specialist, Dr. (b)(6) , appointment is scheduled for 6/28/22.

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
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)
2022-06-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Pfizer-BioNTech
2	2021-04-14	Pfizer-BioNTech
3	2021-12-09	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-06-09	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): Mild Pain @ Injection site early morning. Gone before 12pm.

Release 7 — days 1–6 daily, dose 2

2021-04-16

Systemic reaction (other): I received the vaccine in my left arm. There is an area with a red rash under my left armpit. Additionally, the glands under that armpit are swollen and painful when palpitated.

2021-04-17

Systemic reaction (other): Continuation of symptoms reported yesterday: swelling of glands, pain @ palpitation, and rash in the area beneath my left armpit. The symptoms, most notably the blotchy, red rash, have spread downward a bit since yesterday to the area between my left armpit and towards the top of my left breast area. I have taken photos each day as documentation to share if needed.

2021-04-19

Systemic reaction (other): Vaccine administered in left arm. Glands under left armpit are still moderately swollen. Rash and pain on palpitation are gone.

Release 7 — day 7, dose 2

2021-04-21

Systemic reaction (other): Injection was in left arm. Glands under left armpit are still moderately to slightly swollen.

Release 11 — 12 months, dose 2

2022-04-15

Symptoms: Alopecia Areata

Release 12 — 6 months, dose 3

2022-06-09

Symptoms: Alopecia: 1st small bald patch noticed in August 2021, several months after 2nd Pfizer COVID vaccination. Hair loss increased significantly after Pfizer Booster in Dec. '21, and continues daily 24/7/365. GP referral to Dermatology Specialist 6/28/22. cut off by CDC

Healthcare visit (other): Initial diagnosis of Alopecia Areata made by my GP, Dr. (b)(6) . Dr. (b)(6) referral to Dermatology Specialist, Dr. (b)(6) , appointment is scheduled for 6/28/22.

redacted (b)(6)

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	Alopecia areata	·	·	✓
HCVO	Office visit	·	·	✓
SD	Alopecia areata	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓

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