Z8Z-16036-85994

2 vaccinations 8 coded responses 16 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 968 / HI
Registered: 2021-02-26

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

2021-01-16
Dose 1 — Pfizer-BioNTech
2021-02-26
Registered in v-safe
2021-02-26
Dose 2 — Pfizer-BioNTech
2021-02-26
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia, Sleep disorder — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Sleep disruptions, difficulty getting to sleep due to inability to sleep on my left side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Herpes simplex, Office visit, Oral herpes, Pre-existing disease — Feeling: Fair · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): After 1st Pfizer vaccine, dormant herpes virus was activated, resulting intraoral herpes simplex lesion in gum · Healthcare visit (other): Saw dentist for intraoral herpes outbreak 1st vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Limb discomfort, Sleep disorder — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Some sleep disruption because I sleep on my side and pressure on left arm causes me to awake fro Sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Nodule, Physiotherapy — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Knots in neck and shoulder muscles side of vaccine. Had to go to physical therapy · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Sleep deficit — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: A little sleep deprived

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Survey response — day 28, dose 2
MedDRA: Herpes simplex, Immunisation reaction, Office visit, Pre-existing disease — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Outbreak of herpes simplex virus under my nose, a location Ive never had before. After the first vaccine, I had an outbreak of herpes simplex on my chin and on my gum intraorally. My dentist dx it as COVID vaccine related. · Healthcare visit (other): Saw dr (b)(6) a dermatologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-10
Survey response — day 42, dose 2
MedDRA: Insomnia, Nasal congestion, Rhinorrhoea — Feeling: Poor

Free text: Nasal congestion or runny nose Sleep disruptions, difficulty getting to sleep and difficulty returning to sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-09-22
Call 1 — Left Voicemail
2021-09-27
Call 2 — Left Voicemail
2021-09-27
Call successful
Does not wish to fill out VAERS report
2022-02-28
Survey response — 12 months, dose 2
MedDRA: Cough, Gastrointestinal disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Gastrointestinal problems Residual coughing

MedDRA releases: 2024-11 · check-in free text available
2022-02-28
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-23
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Pfizer-BioNTech
2	2021-02-26	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-01	Successful	Does not wish to fill out VAERS report
2021-03-03	Successful	Does not wish to fill out VAERS report
2021-03-26	Successful 2021-09-27	Does not wish to fill out VAERS report
2022-02-28	Successful 2022-03-23	Does not wish to fill out VAERS report

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Sleep disruptions, difficulty getting to sleep due to inability to sleep on my left side

2021-03-01

Systemic reaction (other): After 1st Pfizer vaccine, dormant herpes virus was activated, resulting intraoral herpes simplex lesion in gum

Healthcare visit (other): Saw dentist for intraoral herpes outbreak 1st vaccine

2021-03-02

Systemic reaction (other): Some sleep disruption because I sleep on my side and pressure on left arm causes me to awake fro Sleep

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Knots in neck and shoulder muscles side of vaccine. Had to go to physical therapy

Healthcare visit (other): Physical therapy

2021-03-04

Systemic reaction (other): A little sleep deprived

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Outbreak of herpes simplex virus under my nose, a location Ive never had before. After the first vaccine, I had an outbreak of herpes simplex on my chin and on my gum intraorally. My dentist dx it as COVID vaccine related.

Healthcare visit (other): Saw dr (b)(6) a dermatologist

redacted (b)(6)

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Nasal congestion or runny nose Sleep disruptions, difficulty getting to sleep and difficulty returning to sleep

Release 11 — 12 months, dose 2

2022-02-28

Symptoms: Gastrointestinal problems Residual coughing

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	Herpes simplex	✓	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Oral herpes	○	✓	○
HCVO	Physiotherapy	✓	✓	✓
HCVO	Pre-existing disease	✓	·	✓
SD	Cough	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Herpes simplex	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Condition aggravated	○	✓	○
SRO	Herpes simplex	✓	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Nodule	✓	✓	✓
SRO	Oral herpes	○	✓	○
SRO	Physiotherapy	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sleep deficit	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓

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