Y8H-25047-84076

5 vaccinations 21 coded responses 57 check-ins 20 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 980 / WA
Registered: 2021-04-06

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea · 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 · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Pre-existing disease, Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: I have other conditions that also cause these symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Symptoms from other conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Symptoms from other conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Survey response — day 14, dose 1
MedDRA: Chills, Cough, Diarrhoea, Dizziness, Fatigue, Hyperhidrosis, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Poor · 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: Excessive fatigue, chills, sweating, dizzy/woozy, diarrhea (just one time), minor temperature increase (1 - 1.5Â°), cough/congestion · Healthcare visit (other): Covid test (it came back negative)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
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)
2021-04-27
Dose 2 — Pfizer-BioNTech
2021-04-27
Survey response — day 0, dose 2
MedDRA: Cough — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · 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: Good · Headache, Muscle or body aches

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-05-11
Survey response — day 14, dose 2
MedDRA: Arthralgia, Back pain, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lower back/hip pain · Healthcare visit (other): Office visit followed by x-rayss

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-18
Survey response — day 21, dose 2
MedDRA: Asthenia, Fatigue, Medical procedure, Musculoskeletal stiffness, Myalgia, Pain, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I had facet joint injections, so is probably caused by those. Muscle stiffness, aching, weakness, fatigue. · Healthcare visit (other): Planned procedure on my back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-01
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper, Arthralgia, Back pain, Diarrhoea, Fatigue, Headache, Neck pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Back pains, hip joint pain, neck pain, diarrhea, stomach pain, headache, exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-27
Survey response — 3 months, dose 2
MedDRA: Abdominal discomfort, Gastric disorder, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Gastric changes and distress · Healthcare visit (other): It's scheduled for next week.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Call 2 — Left Voicemail
2021-10-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-30
Dose 3 — Moderna
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Constipation, Diarrhoea, Self-medication — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: I took milk of magnesia last night for constipation. Probably what caused the diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Survey response — day 42, dose 3
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hip joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Intervertebral disc protrusion — Feeling: Good · Be unable to do your normal daily activities

Free text: Herniated disc

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Survey response — 6 months, dose 3
MedDRA: Unevaluable event — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Unrelated to Covid or the vaccines

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Dose 4 — Moderna
2022-05-20
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-22
Survey response — days 1–6 daily, dose 4
MedDRA: Hyperhidrosis — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sweating, even when temperature went down

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Survey response — days 1–6 daily, dose 4
MedDRA: Chills, Feeling hot, Hyperhidrosis — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Alternating chills with hot. Also, sweating.

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2022-05-25
Survey response — days 1–6 daily, dose 4
MedDRA: Hyperhidrosis — Feeling: Good · Muscle or body aches

Free text: Sweating

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-27
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-17
Survey response — day 28, dose 4
MedDRA: Bronchitis, Medical counselling, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Bronchitis from neighbor's smoke. I have asthma, so I assume this is unrelated to the vaccine. · Healthcare visit (other): Phone calls, might need to go to urgent care if prescription was not phoned in.

MedDRA releases: 2024-11 · check-in free text available
2022-06-17
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-21
Health check-in — 3 months, dose 4
Feeling: Poor

Adult check-in
2022-10-19
Dose 5 — Pfizer-BioNTech
2022-11-18
Survey response — 6 months, dose 4
MedDRA: Back pain, Intervertebral disc protrusion, Lumbar spinal stenosis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Back pain from lumbar herniations and stenosis.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Survey response — day 28, dose 5
MedDRA: Lumbar spinal stenosis, Nerve compression — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lumbar stenosis pinching L5 nerve

MedDRA releases: 2024-11 · check-in free text available
2022-11-23
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-30
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-18
Survey response — 3 months, dose 5
MedDRA: Bronchitis, Dysphonia, Influenza virus test, Medical counselling, Respiratory syncytial virus infection, Respiratory syncytial virus test positive, SARS-CoV-2 test — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-18
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-19
Call 1 — Left Voicemail
2023-01-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-19
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Pfizer-BioNTech
2	2021-04-27	Pfizer-BioNTech
3	2021-10-30	Moderna	No
4	2022-05-20	Moderna	No
5	2022-10-19	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-20	Successful 2022-06-21	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-05-11	Successful 2022-06-21	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-05-18	Successful 2022-06-21	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-07-27	Successful 2022-06-21	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-17	Successful 2022-06-21	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-18	Successful 2023-01-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): I have other conditions that also cause these symptoms.

2021-04-11

Systemic reaction (other): Symptoms from other conditions

2021-04-12

Systemic reaction (other): Symptoms from other conditions

Release 7 — day 14, dose 1

2021-04-20

Symptoms: Excessive fatigue, chills, sweating, dizzy/woozy, diarrhea (just one time), minor temperature increase (1 - 1.5Â°), cough/congestion

Healthcare visit (other): Covid test (it came back negative)

Release 8 — day 0, dose 2

2021-04-27

Systemic reaction (other): Coughing

Release 8 — days 1–6 daily, dose 2

2021-05-03

Systemic reaction (other): Anxiety

Release 8 — day 14, dose 2

2021-05-11

Symptoms: Lower back/hip pain

Healthcare visit (other): Office visit followed by x-rayss

Release 8 — day 21, dose 2

2021-05-18

Symptoms: I had facet joint injections, so is probably caused by those. Muscle stiffness, aching, weakness, fatigue.

Healthcare visit (other): Planned procedure on my back

Release 8 — day 35, dose 2

2021-06-01

Symptoms: Back pains, hip joint pain, neck pain, diarrhea, stomach pain, headache, exhaustion

Release 9 — 3 months, dose 2

2021-07-27

Symptoms: Gastric changes and distress

Healthcare visit (other): It's scheduled for next week.

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): I took milk of magnesia last night for constipation. Probably what caused the diarrhea.

Release 10 — day 42, dose 3

2021-12-11

Symptoms: Hip joint pain

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Herniated disc

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: Unrelated to Covid or the vaccines

Release 11 — days 1–6 daily, dose 4

2022-05-22

Systemic reaction (other): Sweating, even when temperature went down

2022-05-23

Systemic reaction (other): Alternating chills with hot. Also, sweating.

2022-05-25

Systemic reaction (other): Sweating

Release 12 — day 28, dose 4

2022-06-17

Symptoms: Bronchitis from neighbor's smoke. I have asthma, so I assume this is unrelated to the vaccine.

Healthcare visit (other): Phone calls, might need to go to urgent care if prescription was not phoned in.

Release 12 — 6 months, dose 4

2022-11-18

Symptoms: Back pain from lumbar herniations and stenosis.

Release 12 — day 28, dose 5

2022-11-18

Symptoms: Lumbar stenosis pinching L5 nerve

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	·	·	✓
HCVO	Medical procedure	✓	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	SARS-CoV-2 test negative	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal discomfort	✓	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	·	✓
SD	Back pain	✓	✓	✓
SD	Bronchitis	·	·	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dysphonia	·	·	✓
SD	Epigastric discomfort	○	·	○
SD	Facet joint block	○	·	○
SD	Fatigue	✓	✓	✓
SD	Gastric disorder	✓	·	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Influenza virus test	·	·	✓
SD	Intervertebral disc protrusion	·	·	✓
SD	Lumbar spinal stenosis	·	·	✓
SD	Medical counselling	·	·	✓
SD	Musculoskeletal stiffness	✓	·	✓
SD	Myalgia	○	✓	○
SD	Neck pain	✓	✓	✓
SD	Nerve compression	·	·	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Respiratory syncytial virus test positive	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Adverse reaction	✓	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Constipation	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Diarrhoea	·	·	✓
SRO	Feeling hot	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Self-medication	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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