Y3F-28080-31499

5 vaccinations 8 coded responses 36 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 981 / WA
Registered: 2021-03-30

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

2021-03-05
Dose 1 — Pfizer-BioNTech
2021-03-30
Registered in v-safe
2021-03-30
Dose 2 — Pfizer-BioNTech
2021-03-30
Survey response — day 0, dose 2
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Fatigue or tiredness

Free text: Sleep was elusive last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 28, dose 2
MedDRA: Medical counselling, Postmenopausal haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I am a post menopausal woman taking hormones and have not had a period in 14 years. I started to spot yesterday and it is ongoing. Just little drips and dribbles, but disconcerting and worrisome. Wondering if it is because of the vaccine. · Healthcare visit (other): Email conversations with doctor that will lead to a follow up appointment and maybe an untrasound

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-29
Survey response — 3 months, dose 2
MedDRA: Haemorrhage, Menopause, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Break through bleeding. I have been in menopause for 14 years and I have had 2 bouts of break through bleeding since my second shot. I had to increase my progesterone dosage.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call 1 — Left Voicemail
2021-07-16
Call 2 — Left Voicemail
2021-09-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-16
Survey response — day 42, dose 3
MedDRA: Diarrhoea — Feeling: Fair

Free text: Loose stool

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Health check-in — 3 months, dose 3
Feeling: Poor

Adult check-in
2022-04-01
Dose 4 — Moderna
2022-04-15
Survey response — day 14, dose 4
MedDRA: Fatigue — 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: Ever since I received my booster 2 weeks ago, I have had fatigue every afternoon.

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Report sent to call center — day 14, dose 4
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)
2022-04-19
Call successful
Completed over the phone
2022-04-22
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-06
Dose 5 — Moderna
Co-administered: Flu
2022-09-13
Survey response — day 7, dose 5
MedDRA: Pain in extremity — Feeling: Good · Site: Pain, Redness, Swelling

Free text: The symptoms of pain in my arm happened the day of an 3 days after the injection

MedDRA releases: 2024-11 · check-in free text available
2022-09-20
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-09-27
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-06
Survey response — 3 months, dose 5
MedDRA: Headache — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Today I am in bed with a headache.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Pfizer-BioNTech
2	2021-03-30	Pfizer-BioNTech
3	2021-11-04	Moderna	No
4	2022-04-01	Moderna	No
5	2022-09-06	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-04-27	Unsuccessful
2021-06-29	Unsuccessful
2022-04-15	Successful 2022-04-19	Completed over the phone

Free text

Release 6 — day 0, dose 2

2021-03-30

Systemic reaction (other): Exhaustion

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Sleep was elusive last night

Release 8 — day 28, dose 2

2021-04-27

Symptoms: I am a post menopausal woman taking hormones and have not had a period in 14 years. I started to spot yesterday and it is ongoing. Just little drips and dribbles, but disconcerting and worrisome. Wondering if it is because of the vaccine.

Healthcare visit (other): Email conversations with doctor that will lead to a follow up appointment and maybe an untrasound

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: Break through bleeding. I have been in menopause for 14 years and I have had 2 bouts of break through bleeding since my second shot. I had to increase my progesterone dosage.

Release 10 — day 42, dose 3

2021-12-16

Symptoms: Loose stool

Release 11 — day 14, dose 4

2022-04-15

Symptoms: Ever since I received my booster 2 weeks ago, I have had fatigue every afternoon.

Release 12 — day 7, dose 5

2022-09-13

Systemic reaction (other): The symptoms of pain in my arm happened the day of an 3 days after the injection

Release 12 — 3 months, dose 5

2022-12-06

Symptoms: Today I am in bed with a headache.

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	Medical counselling	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Haemorrhage	✓	✓	✓
SD	Headache	·	·	✓
SD	Menopause	✓	✓	✓
SD	Postmenopausal haemorrhage	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Pain in extremity	·	·	✓

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