Y39-11114-45865

5 vaccinations 25 coded responses 38 check-ins 25 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 947 / CA
Registered: 2021-02-11

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

Timeline

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Pfizer-BioNTech
2021-02-11
Health check-in — day 0, dose 1
Feeling: Fair · Fever · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Dyspnoea — Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Light shortness of breath; abdominal discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Free text: Flashed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath needing to use my inhaler.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Fever · Chills, Fatigue or tiredness

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Pruritus, Sensation of foreign body — Feeling: Fair · Fever · Chills, Fatigue or tiredness

Free text: Swollen glands in the throat/neck/ear area. Feel like a lump in the throat when i swallow. Itchiness/burning around head & face and extremities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Balance disorder, Pyrexia — Feeling: Fair

Free text: Unsteadiness; feverish

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Muscle or body aches · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-03-13
Dose 2 — Pfizer-BioNTech
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Fatigue, Myalgia — Feeling: Fair · Site: Pain, Swelling · Abdominal pain

Free text: On the first day I had joint and muscle ache as well as tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Chills, Abdominal pain

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Abdominal pain

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Survey response — day 21, dose 2
MedDRA: Cough, Dizziness — Feeling: Good

Free text: Coughing; light headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 28, dose 2
MedDRA: Cough — Feeling: Fair

Free text: Dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 35, dose 2
MedDRA: Cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-24
Survey response — day 42, dose 2
MedDRA: Cough, Epistaxis, Headache, Paranasal sinus discomfort — Feeling: Fair

Free text: Coughing; nosebleed; light headache; sinus pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Survey response — 3 months, dose 2
MedDRA: Headache, Hypersensitivity, Rhinorrhoea, Sneezing, Somnolence — Feeling: Fair

Free text: Lingering low grade headache & severe allergy ie. sneezing, runny nose, feeling extremely drowsy which may be from BP med.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Call 1 — Left Voicemail
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Chest discomfort, Dyspnoea — Feeling: Good

Free text: Mild shortness of breath in the morning upon waking up and or mild chest tightness.

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-07
Survey response — day 0, dose 3
MedDRA: Dyspnoea, Feeling hot — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Head feels hot. Comes & goes. Had slight shortness of breath after jab but went away.

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-10
Survey response — days 1–6 daily, dose 3
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Sniffles

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Nausea

Adult check-in
2021-10-14
Health check-in — day 7, dose 3
Feeling: Fair · None

Adult check-in
2021-10-21
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-28
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-04
Survey response — day 28, dose 3
MedDRA: Nasal congestion, Sneezing — Feeling: Fair

Free text: Sneezing, nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Dose 4 — Pfizer-BioNTech
2022-09-26
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-29
Survey response — days 1–6 daily, dose 5
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Fair · Site: Pain

Free text: Nasal congestion, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Survey response — days 1–6 daily, dose 5
MedDRA: Rhinorrhoea, Sneezing — Feeling: Fair · Nausea

Free text: Runny nose, sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Survey response — day 7, dose 5
MedDRA: Injection site bruising — Feeling: Fair · Fatigue or tiredness

Free text: Purple bruise a few inches near the injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-10-10
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-17
Survey response — day 21, dose 5
MedDRA: Cluster headache, Fatigue, Gastrointestinal disorder, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feeling feverish, stomach trouble, tiredness, cluster headache.

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Survey response — day 28, dose 5
MedDRA: Abdominal discomfort, Flatulence — Feeling: Fair

Free text: Stomach upset, gas.

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Survey response — day 35, dose 5
MedDRA: Rhinorrhoea, Sneezing — Feeling: Poor

Free text: Sneezing, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-12-26
Survey response — 3 months, dose 5
MedDRA: Rash, Swelling, Swelling face — 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, Outpatient clinic or urgent care clinic visit

Free text: Rash around ears and swelling. A week and a half later, rash and swelling around eyes and face for almost 2 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-12-26
Report sent to call center — 3 months, dose 5
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-27
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Pfizer-BioNTech
2	2021-03-13	Pfizer-BioNTech
3	2021-10-07	Pfizer-BioNTech	Flu
4	2022-04-13	Pfizer-BioNTech	No
5	2022-09-26	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-02-18	Unsuccessful
2021-04-17	Unsuccessful
2022-12-26	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): Light shortness of breath; abdominal discomfort

2021-02-13

Systemic reaction (other): Flashed

2021-02-14

Systemic reaction (other): Shortness of breath needing to use my inhaler.

2021-02-15

Systemic reaction (other): Shortness of breath

2021-02-16

Systemic reaction (other): Swollen glands in the throat/neck/ear area. Feel like a lump in the throat when i swallow. Itchiness/burning around head & face and extremities.

2021-02-17

Systemic reaction (other): Unsteadiness; feverish

Release 4 — day 7, dose 1

2021-02-18

Systemic reaction (other): Shortness of breath

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): On the first day I had joint and muscle ache as well as tiredness

2021-03-17

Systemic reaction (other): Light headed

Release 6 — day 21, dose 2

2021-04-03

Symptoms: Coughing; light headedness

Release 7 — day 28, dose 2

2021-04-10

Symptoms: Dry cough

Release 7 — day 35, dose 2

2021-04-17

Symptoms: Coughing

Release 7 — day 42, dose 2

2021-04-24

Symptoms: Coughing; nosebleed; light headache; sinus pressure

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: Lingering low grade headache & severe allergy ie. sneezing, runny nose, feeling extremely drowsy which may be from BP med.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Mild shortness of breath in the morning upon waking up and or mild chest tightness.

Release 10 — day 0, dose 3

2021-10-07

Systemic reaction (other): Head feels hot. Comes & goes. Had slight shortness of breath after jab but went away.

Release 10 — days 1–6 daily, dose 3

2021-10-10

Systemic reaction (other): Sniffles

Release 10 — day 28, dose 3

2021-11-04

Symptoms: Sneezing, nasal congestion

Release 12 — days 1–6 daily, dose 5

2022-09-29

Systemic reaction (other): Nasal congestion, runny nose

2022-09-30

Systemic reaction (other): Runny nose, sneezing

Release 12 — day 7, dose 5

2022-10-05

Systemic reaction (other): Purple bruise a few inches near the injection site.

Release 12 — day 21, dose 5

2022-10-17

Symptoms: Feeling feverish, stomach trouble, tiredness, cluster headache.

Release 12 — day 28, dose 5

2022-10-24

Symptoms: Stomach upset, gas.

Release 12 — day 35, dose 5

2022-10-31

Symptoms: Sneezing, runny nose

Release 12 — 3 months, dose 5

2022-12-26

Symptoms: Rash around ears and swelling. A week and a half later, rash and swelling around eyes and face for almost 2 weeks

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 discomfort	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cluster headache	·	·	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Epistaxis	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Flatulence	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Swelling	·	·	✓
SD	Swelling face	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	·	·	✓
SRO	Injection site bruising	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sensation of foreign body	✓	✓	✓
SRO	Sneezing	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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