ZBA-59918-74720

2 vaccinations 11 coded responses 25 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 986 / WA
Registered: 2021-03-30

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

2021-03-30
Registered in v-safe
2021-03-30
Dose 1 — Pfizer-BioNTech
2021-03-30
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Chills

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Immediate post-injection reaction, Injection site pruritus, Pain in extremity — Feeling: Good

Free text: Itched at injection site 30 min after shot and again to a lesser degree 60 min after shot. Upper arm was sore for three days, but no worse than a flu shot. Breakfast tasted funny morning after shot. No other symptoms

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 14, dose 1
MedDRA: Asthenia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tired, weak. Sleep a lot since Friday afternoon. No energy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Dose 2 — Pfizer-BioNTech
2021-04-20
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Flashing headaches, better now, but still happen. Dont usually have headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Headache, Pre-existing disease — Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy. Headache due allergies, I believe. Tiredness also thought due to allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 7, dose 2
Feeling: Fair · Site: Swelling · Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-04
Survey response — day 14, dose 2
MedDRA: Contusion, Pain in extremity, Peripheral swelling, Thrombosis — Feeling: Good

Free text: Swollen mostly upper left arm with major bruising. Probable blood clot. Elevated above heart, watched for movement toward shoulder. Sent photo to doctor team, no reply. More bruising now, but swelling down, pain about gone. Rested

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-22
Survey response — 12 months, dose 2
MedDRA: Emergency care, Hypertension, Transient global amnesia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: High blood pressure. Trip to ED Diagnosed with "transient global amnesia". Doing better. See doctor Monday

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Pfizer-BioNTech
2	2021-04-20	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2022-04-22	Successful 2022-04-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — day 0, dose 1

2021-03-30

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 1

2021-03-31

Systemic reaction (other): No

2021-04-01

Systemic reaction (other): No

2021-04-02

Systemic reaction (other): No

2021-04-03

Systemic reaction (other): Itched at injection site 30 min after shot and again to a lesser degree 60 min after shot. Upper arm was sore for three days, but no worse than a flu shot. Breakfast tasted funny morning after shot. No other symptoms

Release 7 — day 14, dose 1

2021-04-13

Symptoms: Very tired, weak. Sleep a lot since Friday afternoon. No energy

Release 7 — day 0, dose 2

2021-04-20

Systemic reaction (other): None

Release 7 — days 1–6 daily, dose 2

2021-04-21

Systemic reaction (other): Flashing headaches, better now, but still happen. Dont usually have headaches

2021-04-23

Systemic reaction (other): Dizzy. Headache due allergies, I believe. Tiredness also thought due to allergies

Release 8 — day 14, dose 2

2021-05-04

Symptoms: Swollen mostly upper left arm with major bruising. Probable blood clot. Elevated above heart, watched for movement toward shoulder. Sent photo to doctor team, no reply. More bruising now, but swelling down, pain about gone. Rested

Release 11 — 12 months, dose 2

2022-04-22

Symptoms: High blood pressure. Trip to ED Diagnosed with "transient global amnesia". Doing better. See doctor Monday

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	Asthenia	✓	✓	✓
SD	Contusion	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Thrombosis	✓	✓	✓
SD	Transient global amnesia	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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