Z3B-16216-74353

3 vaccinations 8 coded responses 31 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 330 / FL
Registered: 2021-03-23

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-23
Registered in v-safe
2021-03-23
Dose 1 — Pfizer-BioNTech
2021-03-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle pain, mild headache, fatigue, but I am not sure what is causing it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Dose 2 — Pfizer-BioNTech
2021-04-15
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Palpitations — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Palpitations, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 28, dose 2
MedDRA: Axillary pain, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Sneezing, runny nose, pain under my arm pit and arm where injection was administered.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 35, dose 2
MedDRA: Abdominal pain, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Saw PCP and requested an US of the abdomen due to abdominal pain. Diagnosed with NAFLD and I do not drink alcohol, vegetarian and 116lbs. Also pain in my abdomen and on my right shoulder and on my back on the right upper side. · Healthcare visit (other): Went to my PCP

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Non-alcoholic fatty liver — Feeling: Good · Be unable to do your normal daily activities

Free text: NAFLD

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Survey response — 6 months, dose 2
MedDRA: Abdominal pain upper, Abdominal tenderness, Back pain, Heart rate increased, Pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Upper abdominal pain Abdominal pain that radiated to my back Tenderness when touching my abdomen Rapid pulse

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-19
Call successful
Participant prefers to complete VAERS report online
2021-11-09
Dose 3 — Moderna
2021-11-20
Health check-in — day 7, dose 3
Feeling: Fair · None

Adult check-in
2021-11-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-14
Survey response — day 35, dose 3
MedDRA: Abdominal pain, Blood cholesterol increased, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cholesterol sky rocketed with no changes in my diet. I am 114lbs and eat mostly a vegetarian diet and exercise regularly. Abdominal pain on right side under ribs and nothing shows on US. · Healthcare visit (other): In person consultation

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-17
Call successful
Participant prefers to complete VAERS report online
2021-12-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-10
Survey response — 6 months, dose 3
MedDRA: Blood pressure abnormal, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Blood pressure issues. Heart palpitations.

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Pfizer-BioNTech
2	2021-04-15	Pfizer-BioNTech
3	2021-11-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-22	Successful	Participant prefers to complete VAERS report online
2021-10-14	Successful 2021-10-19	Participant prefers to complete VAERS report online
2021-12-14	Successful 2021-12-17	Participant prefers to complete VAERS report online

Free text

Release 7 — day 14, dose 1

2021-04-06

Symptoms: Muscle pain, mild headache, fatigue, but I am not sure what is causing it.

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Palpitations, shortness of breath

Release 8 — day 28, dose 2

2021-05-14

Symptoms: Sneezing, runny nose, pain under my arm pit and arm where injection was administered.

Release 8 — day 35, dose 2

2021-05-22

Symptoms: Saw PCP and requested an US of the abdomen due to abdominal pain. Diagnosed with NAFLD and I do not drink alcohol, vegetarian and 116lbs. Also pain in my abdomen and on my right shoulder and on my back on the right upper side.

Healthcare visit (other): Went to my PCP

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: NAFLD

Release 10 — 6 months, dose 2

2021-10-14

Symptoms: Upper abdominal pain Abdominal pain that radiated to my back Tenderness when touching my abdomen Rapid pulse

Release 10 — day 35, dose 3

2021-12-14

Symptoms: Cholesterol sky rocketed with no changes in my diet. I am 114lbs and eat mostly a vegetarian diet and exercise regularly. Abdominal pain on right side under ribs and nothing shows on US.

Healthcare visit (other): In person consultation

Release 11 — 6 months, dose 3

2022-05-10

Symptoms: Blood pressure issues. Heart palpitations.

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	Abdominal pain	✓	✓	✓
SD	Abdominal pain upper	·	·	✓
SD	Abdominal tenderness	·	·	✓
SD	Axillary pain	✓	✓	✓
SD	Back pain	·	·	✓
SD	Blood cholesterol increased	·	·	✓
SD	Blood pressure abnormal	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Non-alcoholic fatty liver	·	·	✓
SD	Pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Palpitations	✓	✓	✓

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