ZBR-10295-85076

3 vaccinations 8 coded responses 25 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 190 / PA
Registered: 2021-05-21

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-29
Dose 1 — Pfizer-BioNTech
2021-05-20
Dose 2 — Pfizer-BioNTech
2021-05-21
Registered in v-safe
2021-05-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Last night I was very short of breath for a few hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-05-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Joint pains, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-27
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-06-03
Survey response — day 14, dose 2
MedDRA: Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities

Free text: I continue to have an itchy rash that comes and goes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-19
Survey response — 3 months, dose 2
MedDRA: Bone pain, Fatigue — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have constant pain in my bones. I'm fatigued all the time. While at first I didn't attribute it to the vaccine, I'm starting to think maybe.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Call successful
Participant prefers to complete VAERS report online
2021-12-10
Dose 3 — Pfizer-BioNTech
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Dyspnoea, Pre-existing disease — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Again last night very briefly I had an episode of shortness of breath. I used my inhaler and that seemed to help.

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-17
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-24
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-31
Survey response — day 21, dose 3
MedDRA: Abdominal discomfort, Diarrhoea, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, stomach discomfort with diarrhea. Fatigue. I'm not inclined to believe it is related to the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-14
Survey response — day 35, dose 3
MedDRA: Abdominal pain, Medical counselling, Postmenopausal haemorrhage — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I've experienced abdominal pain and spotting.. I'm 15 years post menopause. · Healthcare visit (other): Phone consult tests ordered with upcoming appointments

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-17
Call 1 — Left Voicemail
2022-01-21
Survey response — day 42, dose 3
MedDRA: Abdominal pain, Office visit, Urethral haemorrhage, Vaginal haemorrhage — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Bleeding from my urethra or vagina. Abdominal pain · Healthcare visit (other): Urologist and x-rays

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-25
Call 1 — Could Not Reach Participant
2022-01-31
Call 2 — Left Voicemail
2022-03-11
Survey response — 3 months, dose 3
MedDRA: Abdominal pain, Blood urine present, Cystoscopy abnormal, Nephrolithiasis, Surgery, Urogram abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Pain in my abdomen. Blood in my urine. My Dr did a urogram and cystoscopy. I have kidney stones. They think that the bleeding is from that. · Healthcare visit (other): Out patient surgery center procedure. Cystoscopy.

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-29	Pfizer-BioNTech
2	2021-05-20	Pfizer-BioNTech
3	2021-12-10	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-19	Successful 2021-08-24	Participant prefers to complete VAERS report online
2022-01-14	Unsuccessful
2022-01-21	Unsuccessful
2022-03-11	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-21

Systemic reaction (other): Last night I was very short of breath for a few hours.

Release 8 — day 14, dose 2

2021-06-03

Symptoms: I continue to have an itchy rash that comes and goes.

Release 9 — 3 months, dose 2

2021-08-19

Symptoms: I have constant pain in my bones. I'm fatigued all the time. While at first I didn't attribute it to the vaccine, I'm starting to think maybe.

Release 10 — days 1–6 daily, dose 3

2021-12-11

Systemic reaction (other): Again last night very briefly I had an episode of shortness of breath. I used my inhaler and that seemed to help.

Release 10 — day 21, dose 3

2021-12-31

Symptoms: Headache, stomach discomfort with diarrhea. Fatigue. I'm not inclined to believe it is related to the vaccine.

Release 10 — day 35, dose 3

2022-01-14

Symptoms: I've experienced abdominal pain and spotting.. I'm 15 years post menopause.

Healthcare visit (other): Phone consult tests ordered with upcoming appointments

Release 11 — day 42, dose 3

2022-01-21

Symptoms: Bleeding from my urethra or vagina. Abdominal pain

Healthcare visit (other): Urologist and x-rays

Release 11 — 3 months, dose 3

2022-03-11

Symptoms: Pain in my abdomen. Blood in my urine. My Dr did a urogram and cystoscopy. I have kidney stones. They think that the bleeding is from that.

Healthcare visit (other): Out patient surgery center procedure. Cystoscopy.

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	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Surgery	·	·	✓
SD	Abdominal discomfort	·	·	✓
SD	Abdominal pain	·	·	✓
SD	Blood urine present	·	·	✓
SD	Bone pain	✓	·	✓
SD	Cystoscopy abnormal	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	·	✓
SD	Headache	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Postmenopausal haemorrhage	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	Urethral haemorrhage	·	·	✓
SD	Urogram abnormal	·	·	✓
SD	Vaginal haemorrhage	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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