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Z8X-93059-50448

2 vaccinations 6 coded responses 13 check-ins 6 free-text entries 2 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
967 / HI
Registered
2021-05-21
Relationship
Self
Race
Native Hawaiian or other Pacific Islander
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-05-04
    Dose 1 — Pfizer-BioNTech
  2. 2021-05-21
    Registered in v-safe
  3. 2021-05-21
    Survey response — day 14, dose 1
    MedDRA: Amnesia, Chills, Memory impairment — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: I continue to experience chills & memory lapses.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-05-25
    Dose 2 — Pfizer-BioNTech
  5. 2021-05-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Chills, Rash, not including the immediate area around the injection site
    Adult check-in
  6. 2021-05-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: No adverse event — Feeling: Good · Site: Itching · Muscle or body aches, Rash, not including the immediate area around the injection site
    Free text: None
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  8. 2021-06-01
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-06-09
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-06-15
    Survey response — day 21, dose 2
    MedDRA: Balance disorder, Cough, Headache, Nasal congestion, Neck pain, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Nasal congestion, cough, headache, unsteady on my feet, sneezing, neck pain. Temporary only lasting a few hours.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-06-23
    Survey response — day 28, dose 2
    MedDRA: Paranasal sinus discomfort, Rash, Skin irritation — Feeling: Fair · Be unable to work or attend school
    Free text: Irritable sinus discomfort.Skin irritation & rash.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-06-29
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-07-07
    Survey response — day 42, dose 2
    MedDRA: Back pain, Neck pain, Quarantine — Feeling: Good · Be unable to work or attend school, 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: Severe Neck & back pain. Plan to seek medical attention tomorrow after my 14 day quarantine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-07-07
    Report sent to call center — day 42, 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)
  15. 2021-07-13
  16. 2021-08-24
    Health check-in — 3 months, dose 2
    Feeling: Poor
    Adult check-in
  17. 2021-11-23
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2022-05-26
    Survey response — 12 months, dose 2
    MedDRA: Condition aggravated, Depression, Fatigue, Pain, Pre-existing disease — 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: Often I feel much fatigue which trigger my fibromyalgia, chronic pain & especially severe depression.
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-05-26
    Report sent to call center — 12 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
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  20. 2022-05-27

Vaccinations

DoseDateManufacturerCo-administered
12021-05-04Pfizer-BioNTech
22021-05-25Pfizer-BioNTech

Call center

ReportedOutcomeVAERS-related outcome
2021-07-07 Unsuccessful
2022-05-26 Unsuccessful

Free text

Release 8 — day 14, dose 1

2021-05-21

Symptoms: I continue to experience chills & memory lapses.

Release 8 — days 1–6 daily, dose 2

2021-05-30

Systemic reaction (other): None

Release 9 — day 21, dose 2

2021-06-15

Symptoms: Nasal congestion, cough, headache, unsteady on my feet, sneezing, neck pain. Temporary only lasting a few hours.

Release 9 — day 28, dose 2

2021-06-23

Symptoms: Irritable sinus discomfort.Skin irritation & rash.

Release 9 — day 42, dose 2

2021-07-07

Symptoms: Severe Neck & back pain. Plan to seek medical attention tomorrow after my 14 day quarantine.

Release 11 — 12 months, dose 2

2022-05-26

Symptoms: Often I feel much fatigue which trigger my fibromyalgia, chronic pain & especially severe depression.

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

FieldPreferred term2021-092023-042024-11
SDAmnesia ○ ✓ ○
SDBack pain ✓ ✓ ✓
SDBalance disorder ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDCondition aggravated · · ✓
SDCough ✓ ✓ ✓
SDDepression · · ✓
SDFatigue · · ✓
SDHeadache ✓ ✓ ✓
SDMemory impairment ✓ · ✓
SDNasal congestion ✓ ✓ ✓
SDNeck pain ✓ ✓ ✓
SDPain · · ✓
SDParanasal sinus discomfort ✓ ✓ ✓
SDPre-existing disease · · ✓
SDQuarantine ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDSkin irritation ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓

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