Y96-30642-31539

4 vaccinations 9 coded responses 31 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 870 / NM
Registered: 2021-03-22

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

2021-03-20
Dose 1 — Pfizer-BioNTech
2021-03-22
Registered in v-safe
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Nausea

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Pfizer-BioNTech
2021-04-10
Survey response — day 0, dose 2
MedDRA: Injection site bruising, Injection site swelling — Feeling: Fair · Site: Pain, Swelling

Free text: Big bruise at injection site and bump

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion — Feeling: Fair · Site: Pain, Swelling

Free text: Deep large bruise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Injection site bruising — Feeling: Good · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Deep bruise at injection site. Slight cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good

Free text: Still dark big bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Good · Site: Swelling · Headache

Free text: Slight cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Survey response — day 14, dose 2
MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good

Free text: Still have large bruise now turning yellow on arm at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Pfizer-BioNTech
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Alopecia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: After my booster in October my hair started falling out. I lost about 1/3 of it over the next 4 months. It is just starting to grow back · Healthcare visit (other): Dermatology

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-11
Call successful
Participant prefers to complete VAERS report online
2022-06-04
Dose 4 — Pfizer-BioNTech
2022-06-20
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-16
Survey response — day 42, dose 4
MedDRA: Cough, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache. Sore throat cough

MedDRA releases: 2024-11 · check-in free text available
2022-09-03
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-03
Survey response — 6 months, dose 4
MedDRA: Alopecia — Feeling: Good

Free text: Hair started falling out

MedDRA releases: 2024-11 · check-in free text available
2023-06-04
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Pfizer-BioNTech
2	2021-04-10	Pfizer-BioNTech
3	2021-10-22	Pfizer-BioNTech	No
4	2022-06-04	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-10	Successful 2022-04-11	Participant prefers to complete VAERS report online

Free text

Release 7 — day 0, dose 2

2021-04-10

Systemic reaction (other): Big bruise at injection site and bump

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Deep large bruise

2021-04-12

Systemic reaction (other): Deep bruise at injection site. Slight cough

2021-04-13

Systemic reaction (other): Still dark big bruise at injection site

2021-04-15

Systemic reaction (other): Slight cough

Release 7 — day 14, dose 2

2021-04-24

Symptoms: Still have large bruise now turning yellow on arm at injection site

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: After my booster in October my hair started falling out. I lost about 1/3 of it over the next 4 months. It is just starting to grow back

Healthcare visit (other): Dermatology

Release 12 — day 42, dose 4

2022-07-16

Symptoms: Headache. Sore throat cough

Release 12 — 6 months, dose 4

2022-12-03

Symptoms: Hair started falling out

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	·	·	✓
SD	Alopecia	·	·	✓
SD	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Injection site bruising	✓	✓	✓
SD	Injection site discolouration	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓

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