Z3G-14683-85242

4 vaccinations 7 coded responses 52 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 875 / NM
Registered: 2021-01-27

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

2021-01-27
Registered in v-safe
2021-01-27
Dose 1 — Pfizer-BioNTech
2021-01-27
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Symptoms are localized to the injection side of the body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Pfizer-BioNTech
2021-02-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Pollakiuria — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: First 24 hours I experienced heavy urinating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal chest pain — Feeling: Good · Muscle or body aches

Free text: Discomfort on back upper ribs on same side as injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Dose 3 — Pfizer-BioNTech
2021-10-05
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-06
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain in armpit area

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

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

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

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-12
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-19
Survey response — day 14, dose 3
MedDRA: Constipation, Fatigue, Liver disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Fatigue. Constipation. My doctor of oriental medicine says my liver is stressed. I am taking oral glutathione.

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-22
Call 1 — Left Voicemail
2021-10-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-07
Survey response — 3 months, dose 3
MedDRA: Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: After the booster, I experienced a lot of lower leg pain, which seemed to come out of nowhere. It eventually subsided. I heard of that happening to another person so I decided to mention it to you.

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-17
Dose 4 — Moderna
2022-04-17
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-04-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-16
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-17
Survey response — 12 months, dose 4
MedDRA: Influenza — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-17
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-18
Call successful
Does not wish to fill out VAERS report
2023-04-18
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Pfizer-BioNTech
2	2021-02-17	Pfizer-BioNTech
3	2021-10-05	Pfizer-BioNTech	No
4	2022-04-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-19	Successful 2023-04-18	Does not wish to fill out VAERS report
2023-04-17	Successful 2023-04-18	Not applicable - Accidental Reporting

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-30

Systemic reaction (other): Symptoms are localized to the injection side of the body

Release 4 — days 1–6 daily, dose 2

2021-02-19

Systemic reaction (other): First 24 hours I experienced heavy urinating

2021-02-20

Systemic reaction (other): Discomfort on back upper ribs on same side as injection site.

Release 10 — days 1–6 daily, dose 3

2021-10-06

Systemic reaction (other): Pain in armpit area

Release 10 — day 14, dose 3

2021-10-19

Symptoms: Fatigue. Constipation. My doctor of oriental medicine says my liver is stressed. I am taking oral glutathione.

Release 10 — 3 months, dose 3

2022-01-07

Symptoms: After the booster, I experienced a lot of lower leg pain, which seemed to come out of nowhere. It eventually subsided. I heard of that happening to another person so I decided to mention it to you.

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	Constipation	·	·	✓
SD	Fatigue	·	·	✓
SD	Influenza	·	·	✓
SD	Liver disorder	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Pollakiuria	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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