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
-
2021-02-19
Dose 1 — Pfizer-BioNTech
-
2021-04-03
Dose 2 — Janssen/Johnson & Johnson
-
2021-04-09
Registered in v-safe
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-10
Health check-in — day 7, dose 2Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-04-17
- 2021-04-26
- 2021-05-04
- 2021-05-15
-
2021-12-13
Dose 3 — Moderna
-
2021-12-14
Survey response — days 1–6 daily, dose 3MedDRA: 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 activitiesFree text: Severe cramping in legs and shot armMedDRA releases: 2024-11 · check-in free text available
-
2021-12-16
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-12-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea, Abdominal painAdult check-in
-
2021-12-18
Survey response — days 1–6 daily, dose 3MedDRA: Limb mass, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activitiesFree text: A benign lump in the arm where I got the shot has been sore, I don't usually feel it at allMedDRA releases: 2024-11 · check-in free text available
- 2021-12-19
-
2021-12-20
Survey response — day 7, dose 3MedDRA: Dizziness — Feeling: Poor · Fever · Be unable to do your normal daily activitiesFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
-
2021-12-27
Survey response — day 14, dose 3MedDRA: Adverse reaction, Office visit, Sinusitis — Feeling: Poor · Be unable to do your normal daily activitiesFree 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
- 2022-01-12
-
2022-01-19
Survey response — day 35, dose 3MedDRA: 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 consultationFree text: Sinus and ME and fibromyalgia symptoms. No way to tell if anything is vaccine relatedMedDRA releases: 2024-11 · check-in free text available
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2022-01-19
Report sent to call center — day 35, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-01-20
Call successfulParticipant prefers to complete VAERS report online
- 2022-01-26
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2022-03-16
Survey response — 3 months, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
- 2022-12-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-19 | Pfizer-BioNTech | |
| 2 | 2021-04-03 | Janssen/Johnson & Johnson | |
| 3 | 2021-12-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-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
Systemic reaction (other): Severe cramping in legs and shot arm
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
Systemic reaction (other): Dizziness
Release 10 — day 14, dose 3
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
Symptoms: Sinus and ME and fibromyalgia symptoms. No way to tell if anything is vaccine related
Release 11 — 3 months, dose 3
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Adverse reaction | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Neurological symptom | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Limb mass | · | · | ✓ |
| SRO | Muscle spasms | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release