YL8-19055-51903

4 vaccinations 12 coded responses 32 check-ins 12 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 017 / MA
Registered: 2021-03-16

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Pfizer-BioNTech
2021-03-16
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: I think I just happen to be tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Oropharyngeal pain — Feeling: Good

Free text: Slight sore throat and dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Survey response — day 14, dose 1
MedDRA: Pre-existing disease, Seasonal allergy, Sneezing, Throat tightness — Feeling: Good

Free text: My throat was coated yesterday morning (the day before, I got soaked in the rain)Occasional sneezing which is consistent with my seasonal allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation, Flatulence — Feeling: Good · Site: Pain

Free text: Slight constipation and gassiness

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

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Yesterday I felt fatigue but didnt report it.

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: Gait disturbance, Limb discomfort, Mobility decreased — Feeling: Good · Muscle or body aches

Free text: I am limping and unable to lift my leg in a side lift. I dont know if this is because of the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches

Free text: Leg is improving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Dose 3 — Pfizer-BioNTech
2022-04-06
Dose 4 — Moderna
2022-04-09
Survey response — 12 months, dose 2
MedDRA: Intervertebral disc compression — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Compressed disc

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-24
Survey response — day 14, dose 4
MedDRA: Back pain, Pain in extremity — Feeling: Good

Free text: Unrelated back and arm pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Survey response — day 21, dose 4
MedDRA: Arthralgia, Back disorder, Bursitis, Office visit, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Back problem causing hip and leg pain. Bursitis in left arm. · Healthcare visit (other): PCP

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-28
Call 1 — Left Voicemail
2022-05-04
Survey response — day 28, dose 4
MedDRA: Bursitis, Neck pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Left arm bursitis Sore neck

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11
Survey response — day 35, dose 4
MedDRA: Fatigue, Insomnia, Nasopharyngitis, Oropharyngeal discolouration, Patient isolation, SARS-CoV-2 test negative, SARS-CoV-2 test positive — 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 · Telehealth, virtual health, or email health consultation

Free text: Thursday night difficulty sleeping. Friday developed coated throat. Tested negative for COVID. Felt ok until evening. Saturday severe cold symptoms and fatigue. Tested positive for COVID. Started on Paxlovid. Isolating thru end Wed., then masking.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — day 35, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-19
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-06
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-05
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-06
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech
3	2021-10-14	Pfizer-BioNTech	No
4	2022-04-06	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-09	Successful 2022-04-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-27	Unsuccessful
2022-05-04	Successful 2022-05-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11	Successful 2022-05-12	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): I think I just happen to be tired.

2021-03-22

Systemic reaction (other): Slight sore throat and dizziness

Release 6 — day 14, dose 1

2021-03-30

Symptoms: My throat was coated yesterday morning (the day before, I got soaked in the rain)Occasional sneezing which is consistent with my seasonal allergies

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Slight constipation and gassiness

2021-04-11

Systemic reaction (other): Yesterday I felt fatigue but didnt report it.

2021-04-12

Systemic reaction (other): I am limping and unable to lift my leg in a side lift. I dont know if this is because of the vaccine.

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Leg is improving.

Release 11 — 12 months, dose 2

2022-04-09

Symptoms: Compressed disc

Release 11 — day 14, dose 4

2022-04-24

Symptoms: Unrelated back and arm pain

Release 11 — day 21, dose 4

2022-04-27

Symptoms: Back problem causing hip and leg pain. Bursitis in left arm.

Healthcare visit (other): PCP

Release 11 — day 28, dose 4

2022-05-04

Symptoms: Left arm bursitis Sore neck

Release 11 — day 35, dose 4

2022-05-11

Symptoms: Thursday night difficulty sleeping. Friday developed coated throat. Tested negative for COVID. Felt ok until evening. Saturday severe cold symptoms and fatigue. Tested positive for COVID. Started on Paxlovid. Isolating thru end Wed., then masking.

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	Arthralgia	·	·	✓
SD	Back disorder	·	·	✓
SD	Back pain	·	·	✓
SD	Bursitis	·	·	✓
SD	Fatigue	·	·	✓
SD	Insomnia	·	·	✓
SD	Intervertebral disc compression	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal discolouration	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Patient isolation	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Throat tightness	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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