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ZAR-16274-38439

3 vaccinations 6 coded responses 18 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
56-60
ZIP prefix
972 / OR
Registered
2021-04-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-19
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-03
    Dose 2 — Janssen/Johnson & Johnson
  3. 2021-04-09
    Registered in v-safe
  4. 2021-04-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-04-10
    Health check-in — day 7, dose 2
    Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Adult check-in
  6. 2021-04-17
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  7. 2021-04-26
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  8. 2021-05-04
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  9. 2021-05-15
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  10. 2021-12-13
    Dose 3 — Moderna
  11. 2021-12-14
    Survey response — days 1–6 daily, dose 3
    MedDRA: Muscle spasms — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: Severe cramping in legs and shot arm
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-12-16
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  13. 2021-12-17
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea, Abdominal pain
    Adult check-in
  14. 2021-12-18
    Survey response — days 1–6 daily, dose 3
    MedDRA: Limb mass, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Free text: A benign lump in the arm where I got the shot has been sore, I don't usually feel it at all
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-12-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Headache
    Adult check-in
  16. 2021-12-20
    Survey response — day 7, dose 3
    MedDRA: Dizziness — Feeling: Poor · Fever · Be unable to do your normal daily activities
    Free text: Dizziness
    MedDRA releases: 2024-11 · check-in free text available
  17. 2021-12-27
    Survey response — day 14, dose 3
    MedDRA: Adverse reaction, Office visit, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities
    Free text: My booster "side effects" slip into a sinus infection. My healthcare provider suggested that it was not unrelated to the booster due to my immune system.
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-01-12
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  19. 2022-01-19
    Survey response — day 35, dose 3
    MedDRA: Neurological symptom, Unevaluable event — Feeling: Poor · 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
    Free text: Sinus and ME and fibromyalgia symptoms. No way to tell if anything is vaccine related
    MedDRA releases: 2024-11 · check-in free text available
  20. 2022-01-19
    Report sent to call center — day 35, dose 3
    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 · 1 call case(s)
  21. 2022-01-20
    Call successful
    Participant prefers to complete VAERS report online
  22. 2022-01-26
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  23. 2022-03-16
    Survey response — 3 months, dose 3
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: I believe that the last booster caused a flare in my chronic illness, Mast Cell Activation Syndrome and Dysautonomia including but not limited to POTS, have not rest to pre vaccine levels.
    MedDRA releases: 2024-11 · check-in free text available
  24. 2022-12-16
    Health check-in — 12 months, dose 3
    Feeling: Poor
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-19Pfizer-BioNTech
22021-04-03Janssen/Johnson & Johnson
32021-12-13Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-01-19 Successful
2022-01-20
Participant prefers to complete VAERS report online

Free text

Release 10 — days 1–6 daily, dose 3

2021-12-14

Systemic reaction (other): Severe cramping in legs and shot arm

2021-12-18

Systemic reaction (other): A benign lump in the arm where I got the shot has been sore, I don't usually feel it at all

Release 10 — day 7, dose 3

2021-12-20

Systemic reaction (other): Dizziness

Release 10 — day 14, dose 3

2021-12-27

Symptoms: My booster "side effects" slip into a sinus infection. My healthcare provider suggested that it was not unrelated to the booster due to my immune system.

Release 10 — day 35, dose 3

2022-01-19

Symptoms: Sinus and ME and fibromyalgia symptoms. No way to tell if anything is vaccine related

Release 11 — 3 months, dose 3

2022-03-16

Symptoms: I believe that the last booster caused a flare in my chronic illness, Mast Cell Activation Syndrome and Dysautonomia including but not limited to POTS, have not rest to pre vaccine levels.

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
SDAdverse reaction · · ✓
SDCondition aggravated · · ✓
SDNeurological symptom · · ✓
SDOffice visit · · ✓
SDPre-existing disease · · ✓
SDSinusitis · · ✓
SDUnevaluable event · · ✓
SRODizziness · · ✓
SROLimb mass · · ✓
SROMuscle spasms · · ✓
SROPain in extremity · · ✓

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