Z8M-10707-96548

3 vaccinations 8 coded responses 34 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 986 / WA
Registered: 2020-12-21

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

Timeline

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

2020-12-21
Registered in v-safe
2020-12-21
Dose 1 — Pfizer-BioNTech
2020-12-21
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Nausea

Adult check-in
2020-12-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2020-12-28
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-04
Survey response — day 14, dose 1
MedDRA: Arthralgia, Back pain — Feeling: Fair

Free text: Joint pain on legs today. Lower back aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Dose 2 — Pfizer-BioNTech
2021-01-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-13
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-16
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-08
Survey response — day 28, dose 2
MedDRA: Headache, Injection site pain — Feeling: Fair

Free text: Headache, pain at injection sit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-02-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-09-29
Survey response — days 1–6 daily, dose 3
MedDRA: Capillary disorder, Pallor, Peripheral coldness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: All extremities are cool and pale, capillary refill more than 3 seconds. I have never had these symptoms.

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-10-02
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Rhinorrhoea — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Coughing, running nose for 2 days

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-05
Health check-in — day 7, dose 3
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-12
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-19
Survey response — day 21, dose 3
MedDRA: Pruritus, Rash, Secretion discharge — Feeling: Fair

Free text: Rash,itchy skin and more mucus buildup in airway

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-02
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-09
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-28
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-29
Survey response — 6 months, dose 3
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Survey response — 12 months, dose 3
MedDRA: Amnesia, Chest pain, Haemoptysis, Headache, Productive cough, Pyrexia, Taste disorder — 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

Free text: Long lasting fevers, headaches, cough with blood in mucous, pain in chest. Memory problems. Altered taste.

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-29
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-21	Pfizer-BioNTech
2	2021-01-11	Pfizer-BioNTech
3	2021-09-28	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-01-13	priority 2/3
2022-09-28	Successful 2022-09-29	Does not wish to fill out VAERS report

Free text

Release 1 — day 14, dose 1

2021-01-04

Symptoms: Joint pain on legs today. Lower back aches

Release 2 — days 1–6 daily, dose 2

2021-01-16

Systemic reaction (other): Coughing

Release 3 — day 28, dose 2

2021-02-08

Symptoms: Headache, pain at injection sit

Release 9 — days 1–6 daily, dose 3

2021-09-29

Systemic reaction (other): All extremities are cool and pale, capillary refill more than 3 seconds. I have never had these symptoms.

2021-10-02

Systemic reaction (other): Coughing, running nose for 2 days

Release 10 — day 21, dose 3

2021-10-19

Symptoms: Rash,itchy skin and more mucus buildup in airway

Release 11 — 6 months, dose 3

2022-03-29

Symptoms: Back pain

Release 12 — 12 months, dose 3

2022-09-28

Symptoms: Long lasting fevers, headaches, cough with blood in mucous, pain in chest. Memory problems. Altered taste.

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	Amnesia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Haemoptysis	·	·	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Productive cough	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Taste disorder	·	·	✓
SRO	Capillary disorder	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Pallor	·	·	✓
SRO	Peripheral coldness	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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