ZE3-16934-09405

3 vaccinations 11 coded responses 33 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 773 / TX
Registered: 2021-03-17

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

2021-03-15
Dose 1 — Pfizer-BioNTech
2021-03-17
Registered in v-safe
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza like illness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Felt like I had a really bad flu.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza like illness — Feeling: Good · Site: Pain · Fever · Diarrhea

Free text: The worst of the nasty flu like symptoms lasted no more than 36 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Pfizer-BioNTech
2021-04-05
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Received vaccine at 3.30pm. 3.5 hours since vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Thirst — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Fatigue-all I want to do is sleep. And insatiable thirst.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash, Injection site reaction — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Ring around the injection site. 1-1.5 inch around site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — day 42, dose 2
MedDRA: Alopecia, Joint swelling, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Hair lossSwollen ankle (new since last week)Have an appt scheduled on 1 June with a Dr. · Healthcare visit (other): In person appt. scheduled.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Dose 3 — Pfizer-BioNTech
Co-administered: Tetanus
2021-10-15
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-16
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site warmth — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Injection site is warm

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain, Injection site warmth — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Injection area (palm size) is still warm and tender to the touch.

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-23
Survey response — day 7, dose 3
MedDRA: Pain in jaw, Pyrexia, Toothache, Tremor, Vaccine positive rechallenge — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: The fever caused terrible shaking; almost off my feet and my jaw-which again has cause jaw and teeth pain again. Had the same issue with vaccines 1 & 2.

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-04
Survey response — day 21, dose 3
MedDRA: Acute sinusitis, Medical counselling, 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 consultation

Free text: Acute sinusitis, chest-Dr advised to watch for pneumonia. On Amoxicillin 875mg

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — day 21, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-08
Call successful
Does not wish to fill out VAERS report
2021-11-18
Survey response — day 35, dose 3
MedDRA: Ear pain, Office visit, Sinusitis, 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

Free text: Symptoms: Sinusitis. Chest. Pain in ears. Seeing ENT to assess issue as previous dr concerned about Sinusitis going to Pneumonia. · Healthcare visit (other): ENT-Monday 22 Nov

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Report sent to call center — day 35, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-12-01
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-01
Call successful
Participant prefers to complete VAERS report online
2022-10-16
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Pfizer-BioNTech
2	2021-04-05	Pfizer-BioNTech
3	2021-10-14	Pfizer-BioNTech	Tetanus

Call center

Reported	Outcome	VAERS-related outcome
2021-05-17	Successful	Does not wish to fill out VAERS report
2021-11-04	Successful 2021-11-08	Does not wish to fill out VAERS report
2021-11-18	Successful 2021-12-01	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Felt like I had a really bad flu.

2021-03-19

Systemic reaction (other): The worst of the nasty flu like symptoms lasted no more than 36 hours.

Release 6 — day 0, dose 2

2021-04-05

Systemic reaction (other): Received vaccine at 3.30pm. 3.5 hours since vaccination.

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Fatigue-all I want to do is sleep. And insatiable thirst.

2021-04-09

Systemic reaction (other): Ring around the injection site. 1-1.5 inch around site.

Release 8 — day 42, dose 2

2021-05-17

Symptoms: Hair lossSwollen ankle (new since last week)Have an appt scheduled on 1 June with a Dr.

Healthcare visit (other): In person appt. scheduled.

Release 10 — days 1–6 daily, dose 3

2021-10-16

Systemic reaction (other): Injection site is warm

2021-10-17

Systemic reaction (other): Injection area (palm size) is still warm and tender to the touch.

Release 10 — day 7, dose 3

2021-10-23

Systemic reaction (other): The fever caused terrible shaking; almost off my feet and my jaw-which again has cause jaw and teeth pain again. Had the same issue with vaccines 1 & 2.

Release 10 — day 21, dose 3

2021-11-04

Symptoms: Acute sinusitis, chest-Dr advised to watch for pneumonia. On Amoxicillin 875mg

Release 10 — day 35, dose 3

2021-11-18

Symptoms: Sinusitis. Chest. Pain in ears. Seeing ENT to assess issue as previous dr concerned about Sinusitis going to Pneumonia.

Healthcare visit (other): ENT-Monday 22 Nov

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	Acute sinusitis	·	·	✓
SD	Alopecia	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Joint swelling	✓	✓	✓
SD	Medical counselling	·	·	✓
SD	Office visit	·	·	✓
SD	Sinusitis	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site rash	○	✓	○
SRO	Injection site reaction	✓	·	✓
SRO	Injection site warmth	·	·	✓
SRO	Pain in jaw	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Thirst	✓	✓	✓
SRO	Toothache	·	·	✓
SRO	Tremor	·	·	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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