ZBM-34000-05565

2 vaccinations 6 coded responses 21 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 828 / WY
Registered: 2021-01-29

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Pfizer-BioNTech
2021-01-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Survey response — day 14, dose 1
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Coughing in the morning congestion on evenings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Dose 2 — Pfizer-BioNTech
2021-02-19
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site induration, Injection site mass — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Hard lump at injection site

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 · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation, Injection site induration, Injection site nodule — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Constipation, hard knot at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 7, dose 2
MedDRA: Injection site nodule — Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hard knot at injection site, going down slowly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper, Arthralgia, Chills, Decreased appetite, Diarrhoea, Headache, Nausea, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, nausea, with stomach and gut pain, loss of appetite. Chills and low grade fever (99.6Â°F), body aches, aching joints, and headache. It is gradually getting better again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-22
Survey response — 12 months, dose 2
MedDRA: COVID-19 pneumonia, Emergency care, Limb injury, Rehabilitation therapy — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Contracted COVID while staying at a rehabilitaion center to recover from a shoulder injury. First symptoms appeared on Jan. 21, 2022. Positive test on Jan. 25, 2022 when taken to hospital for severe syptoms, including COVID Pneumonia... ongoing... · Healthcare visit (other): Re-admittance to rehab center

MedDRA releases: 2024-11 · check-in free text available
2022-02-22
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Pfizer-BioNTech
2	2021-02-19	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2022-02-22	Successful 2022-02-23	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — day 14, dose 1

2021-02-12

Symptoms: Coughing in the morning congestion on evenings

Release 4 — days 1–6 daily, dose 2

2021-02-22

Systemic reaction (other): Hard lump at injection site

2021-02-25

Systemic reaction (other): Constipation, hard knot at injection site

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Hard knot at injection site, going down slowly

Release 6 — day 35, dose 2

2021-03-26

Symptoms: Diarrhea, nausea, with stomach and gut pain, loss of appetite. Chills and low grade fever (99.6Â°F), body aches, aching joints, and headache. It is gradually getting better again.

Release 11 — 12 months, dose 2

2022-02-22

Symptoms: Contracted COVID while staying at a rehabilitaion center to recover from a shoulder injury. First symptoms appeared on Jan. 21, 2022. Positive test on Jan. 25, 2022 when taken to hospital for severe syptoms, including COVID Pneumonia... ongoing... cut off by CDC

Healthcare visit (other): Re-admittance to rehab center

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	Rehabilitation therapy	·	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Headache	✓	✓	✓
SD	Limb injury	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rehabilitation therapy	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Injection site induration	✓	✓	✓
SRO	Injection site mass	✓	✓	✓
SRO	Injection site nodule	✓	✓	✓

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