Y67-22830-81705

3 vaccinations 5 coded responses 23 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 447 / OH
Registered: 2021-04-05

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

2021-04-01
Dose 1 — Pfizer-BioNTech
2021-04-05
Registered in v-safe
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have had these symptoms for several days. I was better this morning but by afternoon the symptoms returned

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-29
Dose 2 — Pfizer-BioNTech
2021-04-29
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · 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
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-05-06
Health check-in — day 7, dose 2
Feeling: Good · Headache, Joint pains

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-05
Survey response — day 35, dose 2
MedDRA: Headache, Rash — Feeling: Fair

Free text: Headaches, then an unexplainable rash started

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Unusually more joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Survey response — 12 months, dose 2
MedDRA: COVID-19 pneumonia, Disease complication — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Got covid pneumonia back in Jan. Still dealing with complications.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Dose 3 — Moderna
2022-06-21
Survey response — day 42, dose 3
MedDRA: Blood pressure decreased, Cardiac disorder, Confusional state, Dizziness, Dysphonia, Dyspnoea, Hypoaesthesia, Peripheral swelling — 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, Emergency room or emergency department visit, Hospitalization

Free text: Complications with my heart, continued difficulty breathing, BP drops low, lightheaded and dizzy spells, very weak voice upon physical or mental exertion, numbness & swelling in hands, legs, & feet when I do anything, and mental confusion.

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Report sent to call center — day 42, dose 3
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-22
Call 1 — Left Voicemail
2022-06-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Pfizer-BioNTech
2	2021-04-29	Pfizer-BioNTech
3	2022-05-06	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-06-21	Successful 2022-06-24	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-05

Systemic reaction (other): I have had these symptoms for several days. I was better this morning but by afternoon the symptoms returned

Release 8 — day 35, dose 2

2021-06-05

Symptoms: Headaches, then an unexplainable rash started

Release 10 — 6 months, dose 2

2021-10-28

Symptoms: Unusually more joint pain

Release 11 — 12 months, dose 2

2022-04-29

Symptoms: Got covid pneumonia back in Jan. Still dealing with complications.

Release 12 — day 42, dose 3

2022-06-21

Symptoms: Complications with my heart, continued difficulty breathing, BP drops low, lightheaded and dizzy spells, very weak voice upon physical or mental exertion, numbness & swelling in hands, legs, & feet when I do anything, and mental confusion.

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	Blood pressure decreased	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Confusional state	·	·	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Disease complication	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysphonia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓

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