Z8Q-31322-71505

4 vaccinations 8 coded responses 49 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 460 / IN
Registered: 2021-02-14

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

2021-02-12
Dose 1 — Pfizer-BioNTech
2021-02-14
Registered in v-safe
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Injection site pain — Feeling: Good · Site: Pain · Diarrhea

Free text: Pain and bruise around injection site for first 24 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain

Free text: Bruise at injection site. Small.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 7, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Redness

Free text: Still small bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Pfizer-BioNTech
2021-03-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe last evening until 9 am this morning or 42 hours after injection. Rough night. Good now after 9/10 am

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-02
Dose 3 — Pfizer-BioNTech
2021-10-02
Health check-in — day 0, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-03
Survey response — days 1–6 daily, dose 3
MedDRA: Diarrhoea haemorrhagic, Emergency care — Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Bloody diarrhea. Emergency Room

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness, Abdominal pain

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

Adult check-in
2021-10-09
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-16
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-02
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-15
Dose 4 — Moderna
2022-05-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-22
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-05-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-19
Survey response — day 35, dose 4
MedDRA: Fatigue, Heart rate increased — Feeling: Fair

Free text: Tiredness. Fast heartbeat.

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-13
Survey response — 6 months, dose 4
MedDRA: Abdominal pain upper, Chills, Diarrhoea, Emergency care, Malaise, Musculoskeletal chest pain, Pain, Pyrexia, Vomiting — 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 · Emergency room or emergency department visit

Free text: 2 weeks ago received Moderna booster at Walgreens. Within 4 hours became exceeedingly ill. All symptoms. Fever. Severe chills. Body aches. Diarrhea. Vomiting. Stomach cramps. Rib cage pain. 28 hours after shot had to go to ER. 3 IVs.

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-11-15
Call 1 — Left Voicemail
2023-05-15
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Pfizer-BioNTech
2	2021-03-05	Pfizer-BioNTech
3	2021-10-02	Pfizer-BioNTech	No
4	2022-05-15	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-13	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Pain and bruise around injection site for first 24 hours.

2021-02-15

Systemic reaction (other): Bruise at injection site. Small.

Release 4 — day 7, dose 1

2021-02-19

Systemic reaction (other): Still small bruise at injection site

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Loss of appetite

2021-03-07

Systemic reaction (other): Severe last evening until 9 am this morning or 42 hours after injection. Rough night. Good now after 9/10 am

Release 9 — days 1–6 daily, dose 3

2021-10-03

Systemic reaction (other): Bloody diarrhea. Emergency Room

Release 12 — day 35, dose 4

2022-06-19

Symptoms: Tiredness. Fast heartbeat.

Release 12 — 6 months, dose 4

2022-11-13

Symptoms: 2 weeks ago received Moderna booster at Walgreens. Within 4 hours became exceeedingly ill. All symptoms. Fever. Severe chills. Body aches. Diarrhea. Vomiting. Stomach cramps. Rib cage pain. 28 hours after shot had to go to ER. 3 IVs.

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	Abdominal pain upper	·	·	✓
SD	Chills	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Malaise	·	·	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Vomiting	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Diarrhoea haemorrhagic	·	·	✓
SRO	Emergency care	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site pain	✓	✓	✓

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