Y9E-71014-18003

3 vaccinations 14 coded responses 27 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 406 / KY
Registered: 2021-01-12

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Pfizer-BioNTech
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: General symptom — Feeling: Good · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: The symptoms were yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Survey response — day 14, dose 1
MedDRA: Chest pain, Palpitations — Feeling: Good

Free text: Occasional heart palpitations/chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-05
Dose 2 — Pfizer-BioNTech
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Free text: Chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 14, dose 2
MedDRA: Muscle injury, Neck pain, Nerve injury, Spinal cord injury cervical — Feeling: Good · Be unable to do your normal daily activities

Free text: Nerve/muscle injury in C3/trapezius.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 21, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair

Free text: Swollen lymph nodes in collar bone and armpits

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Abnormal menstrual clots, Fatigue, Heavy menstrual bleeding, Irritability — Feeling: Good · Be unable to do your normal daily activities

Free text: Heavier periods with larger and more clots. Greater fatigue and irritability a week before periods.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-05
Dose 3 — Pfizer-BioNTech
2022-01-06
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain upper, Dizziness — Feeling: Fair · Site: Pain, Swelling · Fever · Chills

Free text: Dizziness, stomach pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain, Ear pruritus, Nasal congestion, Oropharyngeal pain, Otorrhoea — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Stuffy nose, itchy/runny/achy ears, achy throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain, Dizziness, Epistaxis, Rhinorrhoea, Sputum discoloured, Throat irritation — Feeling: Good

Free text: Bloody/green nasal mucous, runny nose, slightly itchy throat, chest pain/intermittent light headed ness

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain, Nasal congestion, Rhinorrhoea — Feeling: Good

Free text: Nasal congestion/running, chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2022-01-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — day 21, dose 3
MedDRA: Back pain, COVID-19, Cough, Mood altered, Oropharyngeal pain, Respiratory tract congestion, Tension headache, Throat irritation — 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: Covid 10. Started with small tension in forehead between eyes. Throat itchiness and soreness. Chest congestion. Low back pain. Cough. Moodiness.

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — day 21, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-02
Survey response — day 28, dose 3
MedDRA: Malaise, Office visit, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities

Free text: Retested positive for covid yesterday with a rapid test at Kroger Little Clinic (day 5 retest from day 0). No fever, but have had symptoms for 9-10 days.

MedDRA releases: 2024-11 · check-in free text available
2022-02-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-06
Survey response — 3 months, dose 3
MedDRA: Condition aggravated, Depression, Pre-existing disease — 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 · Outpatient clinic or urgent care clinic visit

Free text: Impetigo (recurring since childhood). Mild depression.

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Report sent to call center — 3 months, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-11
Call 1 — Left Voicemail
2022-04-12
Call 2 — Left Voicemail
2023-01-05
Survey response — 12 months, dose 3
MedDRA: Heavy menstrual bleeding, Menstrual clots, Menstruation irregular — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Pfizer-BioNTech
2	2021-02-05	Pfizer-BioNTech
3	2022-01-05	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-15	priority 2/3
2022-01-28	Successful 2022-01-31	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-06	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): The symptoms were yesterday.

Release 2 — day 14, dose 1

2021-01-26

Symptoms: Occasional heart palpitations/chest pain

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): Chest pain

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Nerve/muscle injury in C3/trapezius.

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Swollen lymph nodes in collar bone and armpits

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Heavier periods with larger and more clots. Greater fatigue and irritability a week before periods.

Release 10 — days 1–6 daily, dose 3

2022-01-06

Systemic reaction (other): Dizziness, stomach pain

2022-01-08

Systemic reaction (other): Stuffy nose, itchy/runny/achy ears, achy throat

2022-01-10

Systemic reaction (other): Bloody/green nasal mucous, runny nose, slightly itchy throat, chest pain/intermittent light headed ness

2022-01-11

Systemic reaction (other): Nasal congestion/running, chest pain

Release 11 — day 21, dose 3

2022-01-28

Symptoms: Covid 10. Started with small tension in forehead between eyes. Throat itchiness and soreness. Chest congestion. Low back pain. Cough. Moodiness.

Release 11 — day 28, dose 3

2022-02-02

Symptoms: Retested positive for covid yesterday with a rapid test at Kroger Little Clinic (day 5 retest from day 0). No fever, but have had symptoms for 9-10 days.

Release 11 — 3 months, dose 3

2022-04-06

Symptoms: Impetigo (recurring since childhood). Mild depression.

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	Abnormal menstrual clots	✓	·	✓
SD	Back pain	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Depression	·	·	✓
SD	Fatigue	✓	·	✓
SD	Heavy menstrual bleeding	✓	·	✓
SD	Irritability	✓	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	·	·	✓
SD	Menstrual clots	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Mood altered	·	·	✓
SD	Muscle injury	✓	✓	✓
SD	Neck pain	○	✓	○
SD	Nerve injury	✓	✓	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Spinal cord injury cervical	✓	·	✓
SD	Tension headache	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Abdominal pain upper	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Ear pruritus	·	·	✓
SRO	Epistaxis	·	·	✓
SRO	General symptom	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Otorrhoea	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sputum discoloured	·	·	✓
SRO	Throat irritation	·	·	✓

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