Z4Z-38907-16151

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 229 / VA
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Pfizer-BioNTech
2021-01-09
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Anosmia — Feeling: Good · Headache, Joint pains, Muscle or body aches

Free text: Sense of smell seems dampened today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-24
Survey response — day 14, dose 1
MedDRA: Arthralgia, Condition aggravated, Mesenteric panniculitis, Pre-existing disease, Self-medication — Feeling: Fair · Be unable to do your normal daily activities

Free text: My joints hurt. They did hurt before but they hurt worse now. I take Original brand relief cbd and 500mg of Naproxen. 1 pill 2x daily.Neither my activity nor work load have increased. I have mesenteric panniculitis and im having a flare up too.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Dose 2 — Pfizer-BioNTech
2021-01-29
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Amnesia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Short term memory glitches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Mild confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Memory impairment — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Mild confusion, forgetfullness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Flare up of all autoimmune issues!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-26
Survey response — day 28, dose 2
MedDRA: Malaise, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I got sick after staying in a hotel for work.Was tested for C-19. Was negative. Boyfriend was at hotel with me he was also sick. He was tested for C-19. His results were also negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Back disorder, Neuropathy peripheral — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, 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: Neuropathy... Cause unknown. EMG scheduled for 8/3.Back problems... Degenerative.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-04
Call 1 — Left Voicemail
2021-08-10
Call successful
Participant prefers to complete VAERS report online
2022-02-05
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Pfizer-BioNTech
2	2021-01-29	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-02-26	Successful	Participant prefers to complete VAERS report online
2021-07-30	Successful 2021-08-10	Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Sense of smell seems dampened today.

Release 2 — day 14, dose 1

2021-01-24

Symptoms: My joints hurt. They did hurt before but they hurt worse now. I take Original brand relief cbd and 500mg of Naproxen. 1 pill 2x daily.Neither my activity nor work load have increased. I have mesenteric panniculitis and im having a flare up too.

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Short term memory glitches

2021-02-01

Systemic reaction (other): Mild confusion

2021-02-04

Systemic reaction (other): Mild confusion, forgetfullness

Release 3 — day 7, dose 2

2021-02-05

Systemic reaction (other): Flare up of all autoimmune issues!

Release 4 — day 28, dose 2

2021-02-26

Symptoms: I got sick after staying in a hotel for work.Was tested for C-19. Was negative. Boyfriend was at hotel with me he was also sick. He was tested for C-19. His results were also negative.

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Neuropathy... Cause unknown. EMG scheduled for 8/3.Back problems... Degenerative.

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	Arthralgia	✓	✓	✓
SD	Back disorder	✓	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Mesenteric panniculitis	○	✓	○
SD	Neuropathy peripheral	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Self-medication	✓	✓	✓
SRO	Amnesia	✓	✓	✓
SRO	Anosmia	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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