YL9-30897-87092

3 vaccinations 10 coded responses 16 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 080 / NJ
Registered: 2021-10-07

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

2021-03-04
Dose 1 — Pfizer-BioNTech
2021-03-25
Dose 2 — Pfizer-BioNTech
2021-10-07
Registered in v-safe
2021-10-07
Dose 3 — Pfizer-BioNTech
2021-10-07
Survey response — day 0, dose 3
MedDRA: Unevaluable event — Feeling: Good · Fever

Free text: Good bu it may be too soon to tell. Only 3 hours!

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains

Free text: Rather tired but not terrible.

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · Chills, Muscle or body aches

Adult check-in
2021-10-10
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site erythema — Feeling: Good · Site: Redness

Free text: Curious why I have a pink area just below the injection site.

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-12
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety, Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Anxiety · Healthcare visit (other): Waiting for a call since there were some chest pains that have now gone away

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: No.

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-21
Survey response — day 14, dose 3
MedDRA: Joint swelling, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Swelling joints. · Healthcare visit (other): Rheumatologist

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-24
Call 1 — Left Voicemail
2021-10-28
Survey response — day 21, dose 3
MedDRA: Arthritis, Pain, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Arthritis flare up Today achey feeling in general.

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-29
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04
Survey response — day 28, dose 3
MedDRA: Unevaluable event, Urinary tract disorder — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Feeling as though I have a UTI . · Healthcare visit (other): Lab test

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-13
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, probably from taking an antibiotic for a UTI.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-07
Survey response — 12 months, dose 3
MedDRA: Cough, Influenza like illness, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Unevaluable event — 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, Outpatient clinic or urgent care clinic visit

Free text: Even though I tested Negative in May for Covid I needed 2 different antibiotics to get rid of a temperature and a serious cough . In September, also ran a fever and tested Positive for Covid . No cough more like a flu. Was treated with Paxlovid .

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-10
Call 1 — Left Voicemail
2022-10-10
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Pfizer-BioNTech	No
2	2021-03-25	Pfizer-BioNTech	No
3	2021-10-07	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-12	Successful 2021-10-29	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-21	Successful 2021-10-29	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-28	Successful 2021-10-29	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04	Successful 2021-11-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-07	Successful 2022-10-10	Participant prefers to complete VAERS report online

Free text

Release 10 — day 0, dose 3

2021-10-07

Systemic reaction (other): Good bu it may be too soon to tell. Only 3 hours!

Release 10 — days 1–6 daily, dose 3

2021-10-08

Systemic reaction (other): Rather tired but not terrible.

2021-10-10

Systemic reaction (other): Curious why I have a pink area just below the injection site.

2021-10-12

Systemic reaction (other): Anxiety

Healthcare visit (other): Waiting for a call since there were some chest pains that have now gone away

2021-10-13

Systemic reaction (other): No.

Release 10 — day 14, dose 3

2021-10-21

Symptoms: Swelling joints.

Healthcare visit (other): Rheumatologist

Release 10 — day 21, dose 3

2021-10-28

Symptoms: Arthritis flare up Today achey feeling in general.

Release 10 — day 28, dose 3

2021-11-04

Symptoms: Feeling as though I have a UTI .

Healthcare visit (other): Lab test

Release 10 — day 35, dose 3

2021-11-13

Symptoms: Diarrhea, probably from taking an antibiotic for a UTI.

Release 12 — 12 months, dose 3

2022-10-07

Symptoms: Even though I tested Negative in May for Covid I needed 2 different antibiotics to get rid of a temperature and a serious cough . In September, also ran a fever and tested Positive for Covid . No cough more like a flu. Was treated with Paxlovid .

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	Chest pain	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthritis	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Joint swelling	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract disorder	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	No adverse event	·	·	✓
SRO	Unevaluable event	·	·	✓

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