Y4Q-19833-06600

4 vaccinations 13 coded responses 48 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 381 / TN
Registered: 2021-03-09

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Pfizer-BioNTech
2021-03-09
Survey response — day 0, dose 1
MedDRA: Fatigue — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Was already fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-30
Dose 2 — Pfizer-BioNTech
2021-03-30
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Note that my normal temp is usually below 98Â° F

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: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Fatigue, Pain, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: No new symptoms, but increased fatigue and aches, especially today. No fever detected. I plan to go to doctor soon. I suspect sinus or ear infection (had mild symptoms before vaccination).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-27
Survey response — day 28, dose 2
MedDRA: Back pain, Brain fog, Fatigue, Pain in extremity — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Worsening pain in back and foot, brain fog and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-28
Survey response — 6 months, dose 2
MedDRA: Hypoaesthesia, Office visit, Pain, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I don't remember when you last contacted me. I developed some numbness and pain in late May, it was treated with NSAIDs and PT and is better. · Healthcare visit (other): Direct consult with NP and orthopedist

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-30
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-01
Dose 3 — Pfizer-BioNTech
2022-04-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-04-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2022-04-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-08
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-22
Survey response — day 21, dose 3
MedDRA: Arthralgia, Dental care, Ear swelling, Myalgia — Feeling: Fair

Free text: swelling behind right ear which could be related to dental work 4/19 also additional joint aches and muscle soreness (but I've had some extra physical exertion)

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Survey response — day 28, dose 3
MedDRA: Diarrhoea, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: nausea, diarrhea, could have been mild food poisoning

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: diarrhea, low grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-03
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Nausea, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, nausea and sleepiness, but I am on medication that may cause these symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-09-13
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-09-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-09-16
Survey response — days 1–6 daily, dose 4
MedDRA: Headache, Injection site warmth, Pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: rea around injection site is hot. But headache and other pain is apparently a flare up of other conditions.

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Itching · Chills, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-09-19
Survey response — days 1–6 daily, dose 4
MedDRA: Abdominal pain, Pre-existing disease — Feeling: Good · Site: Redness · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Abdominal pain pre-existing

MedDRA releases: 2024-11 · check-in free text available
2022-09-20
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-27
Health check-in — day 14, dose 4
Feeling: Poor

Adult check-in
2022-10-04
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-11
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-25
Survey response — day 42, dose 4
MedDRA: Fall, Injury, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I was injured by a fall after a vacation during which I walked a lot. I don't think it has any connection to vaccinations · Healthcare visit (other): Referral to ortho

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — day 42, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-13
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-14
Survey response — 6 months, dose 4
MedDRA: Pain, Pre-existing disease, Respiratory tract congestion — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Pfizer-BioNTech
2	2021-03-30	Pfizer-BioNTech
3	2022-04-01	Pfizer-BioNTech	No
4	2022-09-13	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-09-28	Successful 2021-10-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-25	Successful 2022-10-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — day 0, dose 1

2021-03-09

Systemic reaction (other): Was already fatigued

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Note that my normal temp is usually below 98Â° F

Release 7 — day 14, dose 2

2021-04-15

Symptoms: No new symptoms, but increased fatigue and aches, especially today. No fever detected. I plan to go to doctor soon. I suspect sinus or ear infection (had mild symptoms before vaccination).

Release 8 — day 28, dose 2

2021-04-27

Symptoms: Worsening pain in back and foot, brain fog and fatigue.

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: I don't remember when you last contacted me. I developed some numbness and pain in late May, it was treated with NSAIDs and PT and is better.

Healthcare visit (other): Direct consult with NP and orthopedist

Release 11 — day 21, dose 3

2022-04-22

Symptoms: swelling behind right ear which could be related to dental work 4/19 also additional joint aches and muscle soreness (but I've had some extra physical exertion)

Release 11 — day 28, dose 3

2022-04-29

Symptoms: nausea, diarrhea, could have been mild food poisoning

Release 11 — day 35, dose 3

2022-05-06

Symptoms: diarrhea, low grade fever

Release 12 — 3 months, dose 3

2022-07-03

Symptoms: Diarrhea, nausea and sleepiness, but I am on medication that may cause these symptoms.

Release 12 — days 1–6 daily, dose 4

2022-09-16

Systemic reaction (other): rea around injection site is hot. But headache and other pain is apparently a flare up of other conditions.

2022-09-19

Systemic reaction (other): Abdominal pain pre-existing

Release 12 — day 42, dose 4

2022-10-25

Symptoms: I was injured by a fall after a vacation during which I walked a lot. I don't think it has any connection to vaccinations

Healthcare visit (other): Referral to ortho

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	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Dental care	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Ear swelling	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Injury	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Physiotherapy	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Somnolence	·	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Injection site warmth	·	·	✓
SRO	Pain	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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