ZDT-14513-65664

3 vaccinations 10 coded responses 37 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 957 / CA
Registered: 2021-03-11

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

HXB-33558-10835 Child or adolescent in my care · Male · 2021-08-24

Timeline

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

2021-03-09
Dose 1 — Pfizer-BioNTech
2021-03-11
Registered in v-safe
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Agitation, Dizziness, Feeling cold, Flushing, Musculoskeletal chest pain, Piloerection — Feeling: Poor · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea

Free text: Pain in lower rib area of back, light headed & dizzy, easily agitated, flush, cold with goosebumps,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain upper, Dyspnoea, Eye irritation, Flatulence, Musculoskeletal chest pain, Skin burning sensation — Feeling: Poor · Chills, Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Short of breath, higher heart rate, burning eyes, burning sensation in head, pain in right back rib area, gassy stomach with pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Eructation, Lethargy, Neuralgia, Pain in extremity — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Burping quite a bit, off and on lethargy, nerve pain in shin (no reason to have)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: A little lightheaded/dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Pfizer-BioNTech
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dizziness, Heart rate increased — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Higher heart rate, heavy chest, dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Disturbance in attention, Emergency care, Heart rate increased, Hypertension, Memory impairment — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: High heart rate, caused hypertensive episode & had to go to emergency room, bad cognitive problems where I couldnt get brain to say words and forgot conversation or couldnt bring up thoughts, lack of concentration,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Palpitations — Feeling: Fair · Site: Itching · Chills, Joint pains, Nausea · Be unable to do your normal daily activities

Free text: Brain fog - moderate, palpitations - mild, dizziness - moderate

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · Fever · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-09
Call 1 — Left Voicemail
2021-06-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-19
Dose 3 — Moderna
2021-12-19
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Itching · Chills

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate irregular, Paraesthesia — Feeling: Fair · Site: Redness, Swelling, Itching · Headache · Be unable to do your normal daily activities

Free text: Head zings & Heart rate went to 104 while resting. It's going up and down all day. This isn't normal for me.

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-12-26
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-19
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Autoimmune disorder, Nervous system disorder, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have been diagnosed with an auto immune disease. I have sore hips, feet, and hands. I was a runner before the vaccine. I believe the vaccine affected my immune system. I also have nerve issues in my hands, shoulders, and feet.

MedDRA releases: 2024-11 · check-in free text available
2022-06-19
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-21
Call 2 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-12-19
Survey response — 12 months, dose 3
MedDRA: Joint stiffness, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Very stiff joints in feet. · Healthcare visit (other): In office visit and X-rays

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-20
Call 3 — Left Voicemail
2022-12-20
Call 2 — Left Voicemail
2022-12-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Pfizer-BioNTech
2	2021-03-30	Pfizer-BioNTech
3	2021-12-19	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Unsuccessful
2022-06-19	Unsuccessful
2022-12-19	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Pain in lower rib area of back, light headed & dizzy, easily agitated, flush, cold with goosebumps,

2021-03-12

Systemic reaction (other): Short of breath, higher heart rate, burning eyes, burning sensation in head, pain in right back rib area, gassy stomach with pain.

2021-03-13

Systemic reaction (other): Burping quite a bit, off and on lethargy, nerve pain in shin (no reason to have)

2021-03-14

Systemic reaction (other): A little lightheaded/dizzy

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): Higher heart rate, heavy chest, dizzy

2021-04-01

Systemic reaction (other): High heart rate, caused hypertensive episode & had to go to emergency room, bad cognitive problems where I couldnt get brain to say words and forgot conversation or couldnt bring up thoughts, lack of concentration,

2021-04-03

Systemic reaction (other): Brain fog - moderate, palpitations - mild, dizziness - moderate

Release 10 — days 1–6 daily, dose 3

2021-12-23

Systemic reaction (other): Head zings & Heart rate went to 104 while resting. It's going up and down all day. This isn't normal for me.

Release 12 — 6 months, dose 3

2022-06-19

Symptoms: I have been diagnosed with an auto immune disease. I have sore hips, feet, and hands. I was a runner before the vaccine. I believe the vaccine affected my immune system. I also have nerve issues in my hands, shoulders, and feet.

Release 12 — 12 months, dose 3

2022-12-19

Symptoms: Very stiff joints in feet.

Healthcare visit (other): In office visit and X-rays

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	Office visit	·	·	✓
SD	Arthralgia	·	·	✓
SD	Autoimmune disorder	·	·	✓
SD	Joint stiffness	·	·	✓
SD	Nervous system disorder	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Agitation	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Eructation	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Heart rate irregular	·	·	✓
SRO	Hypertension	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Piloerection	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓

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