ZAD-69544-51077

2 vaccinations 9 coded responses 22 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 797 / TX
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Pfizer-BioNTech
2021-01-28
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold — Feeling: Good · Headache, Joint pains, Fatigue or tiredness, Diarrhea

Free text: I get chilled rather easy so I use a space heater by my lift chair and I also use a blanket to cover up with most of the time, so I have had chills but not the same as fever chills exactly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Pfizer-BioNTech
2021-02-18
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Free text: Drippy nose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Nasal congestion — Feeling: Fair · Site: Pain · Chills, Joint pains, Fatigue or tiredness

Free text: Stuffy nose and slight earaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Joint pains, Muscle or body aches

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: The joint pain and muscle aches are probably related to being 76 years old and with arthritis all over my body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · Chills, Headache, Joint pains, Muscle or body aches

Adult check-in
2021-03-04
Survey response — day 14, dose 2
MedDRA: Asthenia, Cystitis, Fatigue, Tremor — Feeling: Fair · 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: Bladder infection; taking Cipro. Felt very shaky and weak. Very tired today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — day 21, dose 2
MedDRA: Hyposmia — Feeling: Good

Free text: I have noticed in the last few weeks that I have a decreased sense of smell.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Survey response — 3 months, dose 2
MedDRA: Emergency care, Face injury, Fall, Limb injury, Pre-existing disease, Skin laceration — 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: Symptoms: Had some squamous cell places frozen or biopsied and had a bad fall with a hit to my cheek resulting in severe bruising and cut to my upper cheek and an injury to my foot which has been Xrayed but is indefinite of a broken bone X-ray will be repeate · Healthcare visit (other): Paramedics called.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
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)
2021-08-19
Survey response — 6 months, dose 2
MedDRA: Fall, Rhinorrhoea, Rib fracture — Feeling: Fair · Be unable to do your normal daily activities

Free text: Runny nose; broken ribs from a fall

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Pfizer-BioNTech
2	2021-02-18	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-04	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-20	Successful 2021-12-14	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — day 0, dose 1

2021-01-28

Systemic reaction (other): No

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I get chilled rather easy so I use a space heater by my lift chair and I also use a blanket to cover up with most of the time, so I have had chills but not the same as fever chills exactly.

Release 4 — days 1–6 daily, dose 2

2021-02-19

Systemic reaction (other): Drippy nose.

2021-02-21

Systemic reaction (other): Stuffy nose and slight earaches.

2021-02-23

Systemic reaction (other): The joint pain and muscle aches are probably related to being 76 years old and with arthritis all over my body.

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Bladder infection; taking Cipro. Felt very shaky and weak. Very tired today.

Release 5 — day 21, dose 2

2021-03-11

Symptoms: I have noticed in the last few weeks that I have a decreased sense of smell.

Release 8 — 3 months, dose 2

2021-05-20

Symptoms: Had some squamous cell places frozen or biopsied and had a bad fall with a hit to my cheek resulting in severe bruising and cut to my upper cheek and an injury to my foot which has been Xrayed but is indefinite of a broken bone X-ray will be repeate cut off by CDC

Healthcare visit (other): Paramedics called.

Release 9 — 6 months, dose 2

2021-08-19

Symptoms: Runny nose; broken ribs from a fall

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	Emergency care	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Cystitis	✓	✓	✓
SD	Face injury	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hyposmia	✓	✓	✓
SD	Limb injury	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	✓	·	✓
SD	Rib fracture	✓	·	✓
SD	Skin laceration	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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