YZN-28680-15901

4 vaccinations 6 coded responses 30 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 951 / CA
Registered: 2021-04-14

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

2021-04-14
Registered in v-safe
2021-04-14
Dose 1 — Pfizer-BioNTech
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: This rash may not be related since Ive had it before in this same place.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-28
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-12
Dose 2 — Pfizer-BioNTech
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Small pain near hipnot usual, but probably not related, but mentioning just in case.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-11
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-11-17
Dose 3 — Moderna
2021-11-18
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Back pain, Diarrhoea — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: Back and knee pain but probably not related; similarly, mild loose stool (prob not related).

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-24
Survey response — day 7, dose 3
MedDRA: Back pain — Feeling: Fair · Muscle or body aches

Free text: Lower Back pain, prob not related

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-08
Survey response — day 21, dose 3
MedDRA: Chest discomfort, Oesophageal spasm, Office visit, Respiratory disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sudden chest tightening and hard to catch my breath. Went away after about 7 hours. Doctor said it was esophageal spasm.

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-09
Call 1 — Left Voicemail
2021-12-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-16
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-25
Dose 4 — Moderna
2022-05-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Pfizer-BioNTech
2	2021-05-12	Pfizer-BioNTech
3	2021-11-17	Moderna	No
4	2022-04-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-08	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-19

Systemic reaction (other): This rash may not be related since Ive had it before in this same place.

Release 8 — days 1–6 daily, dose 2

2021-05-18

Systemic reaction (other): Small pain near hipnot usual, but probably not related, but mentioning just in case.

Release 10 — days 1–6 daily, dose 3

2021-11-18

Systemic reaction (other): Sore throat

2021-11-20

Systemic reaction (other): Back and knee pain but probably not related; similarly, mild loose stool (prob not related).

Release 10 — day 7, dose 3

2021-11-24

Systemic reaction (other): Lower Back pain, prob not related

Release 10 — day 21, dose 3

2021-12-08

Symptoms: Sudden chest tightening and hard to catch my breath. Went away after about 7 hours. Doctor said it was esophageal spasm.

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	Chest discomfort	·	·	✓
SD	Oesophageal spasm	·	·	✓
SD	Office visit	·	·	✓
SD	Respiratory disorder	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Rash	✓	✓	○

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