YXU-11983-30308

4 vaccinations 6 coded responses 40 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 140 / NY
Registered: 2021-02-20

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

2021-02-18
Dose 1 — Pfizer-BioNTech
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Muscle or body aches

Free text: I have chronic back pain and stomach issues, so I dont think my state has anything to do with the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-02-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Pfizer-BioNTech
2021-03-11
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Good · Headache

Free text: Feels like sinus headache. Not unusual for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches

Adult check-in
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Drug hypersensitivity, Fatigue, Herpes zoster, Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Shingles in JuneAllergic reaction to gabapentin (new)Rash of unknown cause in JulyFatigue from shingles outbreak lasting through at least all of July. · Healthcare visit (other): Doctors office visit

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-15
Call 1 — Left Voicemail
2021-10-04
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-04
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-11
Survey response — day 7, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I have fibromyalgia

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — 3 months, dose 3
Feeling: Fair

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

Adult check-in
2022-10-04
Survey response — 12 months, dose 3
MedDRA: Office visit, Palpitations — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Palpitations and Possible atrial fibrillation · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-06
Call 2 — Left Voicemail
2022-10-06
Call 1 — Left Voicemail
2022-10-12
Dose 4 — Pfizer-BioNTech
2022-10-19
Health check-in — day 7, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-26
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-02
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-09
Survey response — day 28, dose 4
MedDRA: Headache, Malaise, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: I hurt all over, headache, malaise. But I got shingles vaccine yesterday.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-18	Pfizer-BioNTech
2	2021-03-11	Pfizer-BioNTech
3	2021-10-04	Pfizer-BioNTech	Flu
4	2022-10-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-11	Unsuccessful
2022-10-04	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-23

Systemic reaction (other): I have chronic back pain and stomach issues, so I dont think my state has anything to do with the vaccine.

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Feels like sinus headache. Not unusual for me.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Shingles in JuneAllergic reaction to gabapentin (new)Rash of unknown cause in JulyFatigue from shingles outbreak lasting through at least all of July.

Healthcare visit (other): Doctors office visit

Release 10 — day 7, dose 3

2021-10-11

Systemic reaction (other): I have fibromyalgia

Release 12 — 12 months, dose 3

2022-10-04

Symptoms: Palpitations and Possible atrial fibrillation

Healthcare visit (other): Office visit

Release 12 — day 28, dose 4

2022-11-09

Symptoms: I hurt all over, headache, malaise. But I got shingles vaccine yesterday.

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	Drug hypersensitivity	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Malaise	·	·	✓
SD	Pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Rash	·	·	✓
SRO	Pre-existing disease	✓	✓	✓

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