YA5-22852-61176

4 vaccinations 24 coded responses 52 check-ins 23 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 145 / NY
Registered: 2021-04-02

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

2021-04-02
Registered in v-safe
2021-04-02
Dose 1 — Pfizer-BioNTech
2021-04-02
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Swelling

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-23
Dose 2 — Pfizer-BioNTech
2021-04-23
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Swelling

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-30
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-11
Dose 3 — Moderna
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction — Feeling: Fair · 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: Just a note: the side effects really kicked in about 18 hours after the injection.

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Side effects for me were worse than Pfizer vaccine # 2. Not horrible though.

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction, Mobility decreased, Muscular weakness, Tenderness — Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Day 3 post-Moderna booster: I apparently have "Covid arm." The area is about 3" x 6". No pain. Arm movement is limited due to tenderness and weakness.

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Free text: Feeling better today. "Covid arm" symptoms are abating.

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction, Muscular weakness, Tenderness — Feeling: Fair · Site: Redness, Swelling, Itching

Free text: "Covid arm" symptoms continueday 3. Arm is still weak and a little tender. Hoping for big improvement this weekend.

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Hypersensitivity — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Hypersensitivity symptoms continue to decrease.

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Survey response — day 7, dose 3
MedDRA: Immunisation reaction — Feeling: Good · Site: Redness, Swelling, Itching

Free text: COVID arm continues to heal.

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-01
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-08
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-15
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-22
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-12
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-07
Dose 4 — Moderna
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-05-09
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain, Redness, Swelling

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Redness, Swelling

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Redness, Swelling

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — days 1–6 daily, dose 4
MedDRA: Immunisation reaction, Pruritus — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Mild itching began on day 3 post-injection. Not sure if I noted that previously. After booster #2 in December 2021, I had "Covid Arm." Maybe this is a milder form of that.

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Swelling, Itching

Free text: No.

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Itching

Free text: No.

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-05
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-08
Survey response — 12 months, dose 4
MedDRA: Ageusia, Anosmia, Arthralgia, Cough, Decreased appetite, Fatigue, Headache, Lethargy, Myalgia, Pain, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing — Feeling: Good · 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

MedDRA releases: 2024-11
2023-05-08
Report sent to call center — 12 months, 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)
2023-05-09
Call 1 — Requested Callback
2023-05-09
Callback requested for
10:00AM ET
2023-05-09
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	2021-04-02	Pfizer-BioNTech
2	2021-04-23	Pfizer-BioNTech
3	2021-12-11	Moderna	No
4	2022-05-07	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-05-08	Successful 2023-05-09	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — day 0, dose 1

2021-04-02

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 1

2021-04-03

Systemic reaction (other): No

2021-04-04

Systemic reaction (other): No

2021-04-05

Systemic reaction (other): No

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): No

2021-04-07

Systemic reaction (other): No

2021-04-08

Systemic reaction (other): No

Release 7 — day 7, dose 1

2021-04-09

Systemic reaction (other): No

Release 7 — day 0, dose 2

2021-04-23

Systemic reaction (other): No

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): No

Release 10 — days 1–6 daily, dose 3

2021-12-12

Systemic reaction (other): Just a note: the side effects really kicked in about 18 hours after the injection.

2021-12-13

Systemic reaction (other): Side effects for me were worse than Pfizer vaccine # 2. Not horrible though.

2021-12-14

Systemic reaction (other): Day 3 post-Moderna booster: I apparently have "Covid arm." The area is about 3" x 6". No pain. Arm movement is limited due to tenderness and weakness.

2021-12-15

Systemic reaction (other): Feeling better today. "Covid arm" symptoms are abating.

2021-12-16

Systemic reaction (other): "Covid arm" symptoms continueday 3. Arm is still weak and a little tender. Hoping for big improvement this weekend.

2021-12-17

Systemic reaction (other): Hypersensitivity symptoms continue to decrease.

Release 10 — day 7, dose 3

2021-12-18

Systemic reaction (other): COVID arm continues to heal.

Release 11 — days 1–6 daily, dose 4

2022-05-09

Systemic reaction (other): No

2022-05-10

Systemic reaction (other): No

2022-05-11

Systemic reaction (other): No

2022-05-12

Systemic reaction (other): Mild itching began on day 3 post-injection. Not sure if I noted that previously. After booster #2 in December 2021, I had "Covid Arm." Maybe this is a milder form of that.

2022-05-13

Systemic reaction (other): No.

Release 11 — day 7, dose 4

2022-05-14

Systemic reaction (other): No.

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Lethargy	·	·	✓
SD	Myalgia	·	·	✓
SD	Pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sneezing	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Hypersensitivity	·	·	✓
SRO	Immunisation reaction	·	·	✓
SRO	Mobility decreased	·	·	✓
SRO	Muscular weakness	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Tenderness	·	·	✓

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