Y3H-15248-63288

2 vaccinations 7 coded responses 7 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 801 / CO
Registered: 2021-02-16

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

2021-02-13
Dose 1 — Pfizer-BioNTech
2021-02-16
Registered in v-safe
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain, Paraesthesia, Toothache — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Teeth hurt, lymph node pain underarm in same arm where shot was given, pins and needle feelings in legs and hands

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: Burning sensation, Musculoskeletal stiffness, Pain in jaw, Toothache — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stiff neck and stiffness in lower back, jaw and teeth pain, burning sensation in fingers and toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Autoimmune disorder — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have UCTD and I believe this first vaccine has triggered a flare up of my autoimmune disease.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: UCTD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — day 14, dose 1
MedDRA: Arthralgia, Back pain, Balance disorder, Burning sensation, Condition aggravated, Fatigue, Headache, Myalgia, Pain in jaw, Pre-existing disease, Spinal pain, Toothache, Undifferentiated connective tissue disease — 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: UCTD- has flared up since receiving the Pfizer vaccine. Systemic joint and muscle pain, jaw and tooth pain, headache, spinal and lower back pain, burning sensation in fingers and toes. Loss of equilibrium, extreme fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-06
Dose 2 — Pfizer-BioNTech
2021-03-06
Survey response — day 0, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · 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: UCTD - been in a flare up since the first shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Report sent to call center — day 0, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Condition aggravated, Lymph node pain, Myalgia, Neuralgia, Pre-existing disease, Undifferentiated connective tissue disease — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · 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: Received the 2nd vaccine yesterday and the symptoms of my autoimmune disease have exacerbated with severe loins, muscle , nerve and lymph node pain. I have UCTD.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Pfizer-BioNTech
2	2021-03-06	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-02-27	Unsuccessful
2021-03-06	Unsuccessful
2021-03-07	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): Teeth hurt, lymph node pain underarm in same arm where shot was given, pins and needle feelings in legs and hands

2021-02-17

Systemic reaction (other): Stiff neck and stiffness in lower back, jaw and teeth pain, burning sensation in fingers and toes

2021-02-18

Systemic reaction (other): I have UCTD and I believe this first vaccine has triggered a flare up of my autoimmune disease.

Release 4 — day 7, dose 1

2021-02-20

Systemic reaction (other): UCTD

Release 4 — day 14, dose 1

2021-02-27

Symptoms: UCTD- has flared up since receiving the Pfizer vaccine. Systemic joint and muscle pain, jaw and tooth pain, headache, spinal and lower back pain, burning sensation in fingers and toes. Loss of equilibrium, extreme fatigue.

Release 5 — day 0, dose 2

2021-03-06

Systemic reaction (other): UCTD - been in a flare up since the first shot.

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Received the 2nd vaccine yesterday and the symptoms of my autoimmune disease have exacerbated with severe loins, muscle , nerve and lymph node pain. I have UCTD.

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	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Balance disorder	✓	·	✓
SD	Burning sensation	✓	·	✓
SD	Condition aggravated	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Spinal pain	✓	✓	✓
SD	Toothache	✓	✓	✓
SD	Undifferentiated connective tissue disease	○	✓	○
SRO	Autoimmune disorder	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Undifferentiated connective tissue disease	○	✓	○
SRO	Unevaluable event	✓	✓	✓

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