Z27-45470-75959

4 vaccinations 5 coded responses 31 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 430 / OH
Registered: 2021-03-20

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

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Pfizer-BioNTech
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: COVID-19, Injection site erythema — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: I noticed that where I usually give blood on the same arm I received a Covid-19 vaccine shot was more red. It eventually faded, but I thought that was strange. Otherwise, I feel fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Tenderness — Feeling: Good · Muscle or body aches

Free text: I've had some tenderness around my left arm, shoulder and neck area part of yesterday and today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspepsia — Feeling: Fair · Fatigue or tiredness

Free text: I had a sour stomach earlier, but it could have been something I ate.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-04-10
Dose 2 — Pfizer-BioNTech
2021-04-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Blood pressure increased, Conjunctival haemorrhage, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had a subconjunctival hemorrhage in my right eye, but my Optometrist said that nothing looked majorly wrong other than I showed signs of slight high blood pressure. My blood pressure has been normal lately. · Healthcare visit (other): office visit

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-14
Dose 3 — Pfizer-BioNTech
Co-administered: Shingles
2021-12-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-20
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-19
Survey response — 6 months, dose 4
MedDRA: Bronchitis — Feeling: Fair · Be unable to work or attend school, 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: Bronchitis

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-20
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Pfizer-BioNTech
2	2021-04-10	Pfizer-BioNTech
3	2021-11-14	Pfizer-BioNTech	Shingles
4	2022-04-20	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-09	Successful 2021-12-09	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-19	Successful 2022-10-20	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

2021-03-21

Systemic reaction (other): I noticed that where I usually give blood on the same arm I received a Covid-19 vaccine shot was more red. It eventually faded, but I thought that was strange. Otherwise, I feel fine.

2021-03-24

Systemic reaction (other): I've had some tenderness around my left arm, shoulder and neck area part of yesterday and today.

2021-03-25

Systemic reaction (other): I had a sour stomach earlier, but it could have been something I ate.

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: I had a subconjunctival hemorrhage in my right eye, but my Optometrist said that nothing looked majorly wrong other than I showed signs of slight high blood pressure. My blood pressure has been normal lately.

Healthcare visit (other): office visit

Release 12 — 6 months, dose 4

2022-10-19

Symptoms: Bronchitis

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	Blood pressure increased	·	·	✓
SD	Bronchitis	·	·	✓
SD	Conjunctival haemorrhage	·	·	✓
SRO	COVID-19	✓	✓	○
SRO	Dyspepsia	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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