Z6D-17597-77984

4 vaccinations 25 coded responses 43 check-ins 25 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 144 / NY
Registered: 2021-03-23

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

2021-03-22
Dose 1 — Pfizer-BioNTech
2021-03-23
Registered in v-safe
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness

Free text: I feel like I am in a fog.

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

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Felt like I was in a fog state again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — day 14, dose 1
MedDRA: Arthralgia, Fatigue, Somnolence — Feeling: Poor · Be unable to do your normal daily activities

Free text: Exhausted and falling asleep while eating supper with family. Pain in my hips thats unexplainable.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Pfizer-BioNTech
2021-04-14
Survey response — day 0, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lower leg pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ringing of my ears since yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Limb discomfort, Tinnitus — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ear ringing and lower leg discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: I didnt think much about it after my first dose but the front of my lower legs feel a burning sensation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Skin burning sensation — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Continue to feel burning skin feeling on my front lower legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation — Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Continue to have burning sensation on my fore legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 21, dose 2
MedDRA: Fatigue, Hyperhidrosis, Nausea, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Continued fatigue, fever, nausea, continued leg issues, soaking sweats.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 28, dose 2
MedDRA: Neuralgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Severe pain in my brachial plexus nerve.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 35, dose 2
MedDRA: Neuralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Having nerve pain down my left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 42, dose 2
MedDRA: Cold sweat, Diarrhoea, Nausea, Neuralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continue to have left arm nerve pain. Also have developed GI symptoms. Nausea, diarrhea. Cold sweats.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Abdominal pain upper, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in my right quadrant of my stomach. · Healthcare visit (other): In person dr. Visit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-22
Call 1 — Left Voicemail
2021-09-28
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-13
Survey response — 6 months, dose 2
MedDRA: COVID-19 — 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

Free text: Was diagnosed with Covid-19 the beginning of September.

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Report sent to call center — 6 months, dose 2
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)
2021-10-14
Survey response — day 14, dose 3
MedDRA: Back pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe lower back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Call 1 — Left Voicemail
2021-10-19
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-02
Survey response — day 35, dose 3
MedDRA: Chills, Hyperhidrosis, Oropharyngeal pain, Pyrexia, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Low grade fever, chills and sweats, sore throat, slightly runny nose.

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Survey response — day 42, dose 3
MedDRA: Asthenia, Hyperhidrosis, Oropharyngeal pain — Feeling: Poor · 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: Sore throat, sweats, feeling weak

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Report sent to call center — day 42, dose 3
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)
2021-11-12
Call 1 — Left Voicemail
2021-12-29
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-29
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-09-18
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-09-20
Survey response — days 1–6 daily, dose 4
MedDRA: Vertigo — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: My ancillary lymph nodes are the size of a baseball

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My lymph nodes under my underarms are still the size of a baseball

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swelling of the lymph nodes under my arms. Size of a golf ball today.

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Continue to have swelling under my arms. Size of a baseball

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Health check-in — day 7, dose 4
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-02
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-09
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-18
Survey response — day 28, dose 4
MedDRA: Erythema — Feeling: Fair

Free text: Tiny red spots on my lower legs

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Health check-in — day 35, dose 4
Feeling: Poor

Adult check-in
2022-10-30
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-12-18
Survey response — 3 months, dose 4
MedDRA: Malaise, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activities

Free text: I have experienced Covid symptoms but test negative for Covid. It's been going on for 2 month.

MedDRA releases: 2024-11 · check-in free text available
2023-03-19
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Pfizer-BioNTech
2	2021-04-14	Pfizer-BioNTech
3	2021-09-28	Pfizer-BioNTech	Flu
4	2022-09-18	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-07-14	Unsuccessful
2021-10-13	Unsuccessful
2021-11-09	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): I feel like I am in a fog.

2021-03-26

Systemic reaction (other): Felt like I was in a fog state again

Release 6 — day 14, dose 1

2021-04-05

Symptoms: Exhausted and falling asleep while eating supper with family. Pain in my hips thats unexplainable.

Release 7 — day 0, dose 2

2021-04-14

Systemic reaction (other): Lower leg pain

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Ringing of my ears since yesterday

2021-04-16

Systemic reaction (other): Ear ringing and lower leg discomfort

2021-04-17

Systemic reaction (other): I didnt think much about it after my first dose but the front of my lower legs feel a burning sensation.

2021-04-18

Systemic reaction (other): Continue to feel burning skin feeling on my front lower legs

2021-04-19

Systemic reaction (other): Continue to have burning sensation on my fore legs

Release 8 — day 21, dose 2

2021-05-05

Symptoms: Continued fatigue, fever, nausea, continued leg issues, soaking sweats.

Release 8 — day 28, dose 2

2021-05-13

Symptoms: Severe pain in my brachial plexus nerve.

Release 8 — day 35, dose 2

2021-05-19

Symptoms: Having nerve pain down my left arm.

Release 8 — day 42, dose 2

2021-05-26

Symptoms: Continue to have left arm nerve pain. Also have developed GI symptoms. Nausea, diarrhea. Cold sweats.

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: Pain in my right quadrant of my stomach.

Healthcare visit (other): In person dr. Visit.

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: Was diagnosed with Covid-19 the beginning of September.

Release 10 — day 14, dose 3

2021-10-14

Symptoms: Severe lower back pain

Release 10 — day 35, dose 3

2021-11-02

Symptoms: Low grade fever, chills and sweats, sore throat, slightly runny nose.

Release 10 — day 42, dose 3

2021-11-09

Symptoms: Sore throat, sweats, feeling weak

Release 12 — days 1–6 daily, dose 4

2022-09-20

Systemic reaction (other): Vertigo

2022-09-21

Systemic reaction (other): My ancillary lymph nodes are the size of a baseball

2022-09-22

Systemic reaction (other): My lymph nodes under my underarms are still the size of a baseball

2022-09-23

Systemic reaction (other): Swelling of the lymph nodes under my arms. Size of a golf ball today.

2022-09-24

Systemic reaction (other): Continue to have swelling under my arms. Size of a baseball

Release 12 — day 28, dose 4

2022-10-18

Symptoms: Tiny red spots on my lower legs

Release 12 — 3 months, dose 4

2022-12-18

Symptoms: I have experienced Covid symptoms but test negative for Covid. It's been going on for 2 month.

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 upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Back pain	·	·	✓
SD	Chills	·	·	✓
SD	Cold sweat	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Erythema	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nausea	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Somnolence	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vertigo	·	·	✓

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