YHC-14928-49340

2 vaccinations 9 coded responses 22 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 480 / MI
Registered: 2021-04-19

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

M59-72021-36032 Child or adolescent in my care · Female · 2021-11-09

LYA-32857-15913 Child or adolescent in my care · Male · 2021-11-09

WLT-13723-91600 Child or adolescent in my care · Male · 2021-11-09

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-19
Registered in v-safe
2021-04-19
Dose 1 — Pfizer-BioNTech
2021-04-19
Health check-in — day 0, dose 1
Feeling: Fair · Diarrhea

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-03
Survey response — day 14, dose 1
MedDRA: Injection site pain, Injection site warmth, Muscle fatigue — Feeling: Fair

Free text: Upper arm of injection site has been on and off warm, sore, fatigued, and mildly burning since day 8 post injection. Nothing severe, but annoying. No visible skin issues. To redness. No rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Dose 2 — Pfizer-BioNTech
2021-05-10
Survey response — day 0, dose 2
MedDRA: Medical counselling — Feeling: Fair · Site: Pain, Itching · Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Constant burning sensation and tenderness of arm on injection side from elbow to neck starting day 8 post dose 1 and continuous until this moment. · Healthcare visit (other): Contact health department

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Pain at original injection site on opposite arm as well as new injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Injection site pruritus — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Original injection site (opposite arm) pain returned and itching and burning still present since day 8 after first injection from elbow to neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Muscle fatigue — Feeling: Fair

Free text: Original injection site in opposite arm still burning near mid upper arm and shoulder and muscle is fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Muscle fatigue — Feeling: Good

Free text: Fatigued muscle and slight burning sensation from shoulder to neck on side of original injection in opposite arm to second injection, since day 8

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Injection site warmth — Feeling: Fair · Headache, Muscle or body aches

Free text: Original injection site on opposite arm warm and burning sensation near shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — day 7, dose 2
MedDRA: Arthralgia, Burning sensation, Injection site pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Original injection site in opposite arm sore and shoulder muscle has burning sensation since day 8

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 14, dose 2
MedDRA: Arthralgia, Pain in extremity, Shoulder injury related to vaccine administration — Feeling: Poor · Be unable to do your normal daily activities

Free text: Shoulder and arm pain since several days after first injection was administered. Suspect SIRVA. Will be seeking medical treatment next week if not resolved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 21, dose 2
Feeling: Poor

Adult check-in
2021-06-07
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-08-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-09
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-15
Call 1 — Could Not Reach Participant
2022-04-20
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	2021-04-19	Pfizer-BioNTech
2	2021-05-10	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-10	Successful 2022-04-20	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 8 — day 14, dose 1

2021-05-03

Symptoms: Upper arm of injection site has been on and off warm, sore, fatigued, and mildly burning since day 8 post injection. Nothing severe, but annoying. No visible skin issues. To redness. No rash.

Release 8 — day 0, dose 2

2021-05-10

Systemic reaction (other): Constant burning sensation and tenderness of arm on injection side from elbow to neck starting day 8 post dose 1 and continuous until this moment.

Healthcare visit (other): Contact health department

Release 8 — days 1–6 daily, dose 2

2021-05-11

Systemic reaction (other): Pain at original injection site on opposite arm as well as new injection site.

2021-05-12

Systemic reaction (other): Original injection site (opposite arm) pain returned and itching and burning still present since day 8 after first injection from elbow to neck

2021-05-14

Systemic reaction (other): Original injection site in opposite arm still burning near mid upper arm and shoulder and muscle is fatigued

2021-05-15

Systemic reaction (other): Fatigued muscle and slight burning sensation from shoulder to neck on side of original injection in opposite arm to second injection, since day 8

2021-05-16

Systemic reaction (other): Original injection site on opposite arm warm and burning sensation near shoulder

Release 8 — day 7, dose 2

2021-05-17

Systemic reaction (other): Original injection site in opposite arm sore and shoulder muscle has burning sensation since day 8

Release 8 — day 14, dose 2

2021-05-26

Symptoms: Shoulder and arm pain since several days after first injection was administered. Suspect SIRVA. Will be seeking medical treatment next week if not resolved.

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	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Muscle fatigue	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Shoulder injury related to vaccine administration	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Muscle fatigue	✓	✓	✓

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