ZAG-88632-56757

5 vaccinations 12 coded responses 41 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 775 / TX
Registered: 2020-12-24

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

2020-12-20
Dose 1 — Pfizer-BioNTech
2020-12-24
Registered in v-safe
2020-12-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Survey response — day 14, dose 1
MedDRA: Oropharyngeal pain, Ulcer — Feeling: Fair

Free text: Sudden onset of unilateral sore throat - deceased over period of 5 hours. Visible small ulcer like lesion noted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Dose 2 — Pfizer-BioNTech
2021-01-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 2
MedDRA: Herpes simplex, Herpes zoster reactivation, Hypoaesthesia, Paraesthesia, Pre-existing disease — Feeling: Good · Site: Pain, Swelling · Rash, not including the immediate area around the injection site

Free text: Numbness and tingling in 2 fingers of hand, zoster breakout

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-02-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-13
Survey response — 6 months, dose 2
MedDRA: Haematocrit decreased, Iron deficiency anaemia, Muscle strain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pulled muscle in left groin and leg.Drop in hematocrit - iron deficient anemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-21
Call 1 — Left Voicemail
2021-07-21
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-14
Dose 3 — Pfizer-BioNTech
2022-01-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-19
Dose 4 — Moderna
2022-06-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-21
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Fever

Free text: Swelling and pain in axilla - same side as injection site

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Swollen lymph nodes in axilla of arm injected

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Survey response — days 1–6 daily, dose 4
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Swollen and painful lymph nodes- axillary, subclavicular and side of breast - side of injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-06-24
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Breast pain, Breast swelling, Oedema peripheral, Pain, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Continue to experience painful swelling in axilla, subclavicular and side by breast on injection side of body

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Survey response — days 1–6 daily, dose 4
MedDRA: Breast swelling, Oedema peripheral, Swelling — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Continue to have swelling axilla, subclavicular and to side of breast.

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Survey response — day 7, dose 4
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Swelling, Itching

Free text: Continued mild lymph node swelling

MedDRA releases: 2024-11 · check-in free text available
2022-07-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-17
Survey response — day 28, dose 4
MedDRA: Adverse reaction — Feeling: Good

Free text: Allergy symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-07-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-31
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-18
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-16
Dose 5 — Moderna
Co-administered: Flu
2022-10-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-10-23
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-30
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-06
Survey response — day 21, dose 5
MedDRA: Respiratory tract congestion, Sneezing — Feeling: Good

Free text: Congestion and sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-21
Survey response — day 35, dose 5
MedDRA: Osteoarthritis — Feeling: Fair

Free text: Osteoarthritis

MedDRA releases: 2024-11 · check-in free text available
2022-11-27
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-15
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-17
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-20	Pfizer-BioNTech
2	2021-01-12	Pfizer-BioNTech
3	2021-10-14	Pfizer-BioNTech	No
4	2022-06-19	Moderna	No
5	2022-10-16	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-07-13	Successful 2021-07-21	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 1 — day 14, dose 1

2021-01-03

Symptoms: Sudden onset of unilateral sore throat - deceased over period of 5 hours. Visible small ulcer like lesion noted.

Release 1 — days 1–6 daily, dose 2

2021-01-14

Systemic reaction (other): Numbness and tingling in 2 fingers of hand, zoster breakout

Release 9 — 6 months, dose 2

2021-07-13

Symptoms: Pulled muscle in left groin and leg.Drop in hematocrit - iron deficient anemia

Release 12 — days 1–6 daily, dose 4

2022-06-21

Systemic reaction (other): Swelling and pain in axilla - same side as injection site

2022-06-22

Systemic reaction (other): Swollen lymph nodes in axilla of arm injected

2022-06-23

Systemic reaction (other): Swollen and painful lymph nodes- axillary, subclavicular and side of breast - side of injection site.

2022-06-24

Systemic reaction (other): Continue to experience painful swelling in axilla, subclavicular and side by breast on injection side of body

2022-06-25

Systemic reaction (other): Continue to have swelling axilla, subclavicular and to side of breast.

Release 12 — day 7, dose 4

2022-06-26

Systemic reaction (other): Continued mild lymph node swelling

Release 12 — day 28, dose 4

2022-07-17

Symptoms: Allergy symptoms

Release 12 — day 21, dose 5

2022-11-06

Symptoms: Congestion and sneezing

Release 12 — day 35, dose 5

2022-11-21

Symptoms: Osteoarthritis

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	Adverse reaction	·	·	✓
SD	Haematocrit decreased	✓	✓	✓
SD	Iron deficiency anaemia	✓	✓	✓
SD	Muscle strain	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Osteoarthritis	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sneezing	·	·	✓
SD	Ulcer	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Breast pain	·	·	✓
SRO	Breast swelling	·	·	✓
SRO	Herpes simplex	✓	·	✓
SRO	Herpes zoster reactivation	○	✓	○
SRO	Hypoaesthesia	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Swelling	·	·	✓

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