ZF6-33969-36845

4 vaccinations 13 coded responses 38 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 076 / NJ
Registered: 2021-01-18

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

2021-01-18
Registered in v-safe
2021-01-18
Dose 1 — Pfizer-BioNTech
2021-01-18
Survey response — day 0, dose 1
MedDRA: Pruritus, Self-medication — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Itching on stomach, hands, back of legsResolved with 1 benedryl

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Site: Itching

Free text: Slight Itching in upper arms and back on and off all day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Felt exhausted all morning better now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Good · Joint pains, Muscle or body aches

Free text: Both slight

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Pfizer-BioNTech
2021-02-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
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
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Rhinorrhoea, Throat irritation — Feeling: Good · Headache

Free text: Runny stuffed nose scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Fatigue or tiredness

Free text: Itching ( hands legs body) now and then

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — day 7, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Mild itching on back legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 35, dose 2
MedDRA: Abdominal discomfort, Diarrhoea, Nausea, Pain — Feeling: Fair

Free text: Nausea aches stomach upset diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — 3 months, dose 2
MedDRA: Bronchitis, Fatigue, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bronchitis discovered in pre op check up( for cataract removal) 4/30Since medications for this ( antibiotic and steroids for lungs)have been unusually tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Dose 3 — Other-Unknown
2022-02-08
Survey response — 12 months, dose 2
MedDRA: Herpes zoster, Nasopharyngitis, Unevaluable event — 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

Free text: Symptoms: Bad cold late December lasting 10 days Shingles developed since mid January · Healthcare visit (other): PCR test from HNH

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-10
Call successful
Participant prefers to complete VAERS report online
2022-07-18
Dose 4 — Moderna
2022-07-19
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling · None

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-07-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-25
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-08-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-15
Survey response — day 28, dose 4
MedDRA: Fatigue, Rhinorrhoea — Feeling: Good

Free text: Runny nose fatigue Rapid negative

MedDRA releases: 2024-11 · check-in free text available
2022-08-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-17
Survey response — 3 months, dose 4
MedDRA: Blood pressure increased, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Blood pressure elevated · Healthcare visit (other): MD visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-16
Survey response — 6 months, dose 4
MedDRA: Fatigue, Nasopharyngitis, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-16
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-17
Call 1 — Left Voicemail
2023-01-17
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Pfizer-BioNTech
2	2021-02-08	Pfizer-BioNTech
3	2021-10-06	Other-Unknown	No
4	2022-07-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-08	Successful 2022-02-10	Participant prefers to complete VAERS report online
2022-10-17	Successful 2022-10-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-16	Successful 2023-01-17	Participant prefers to complete VAERS report online

Free text

Release 2 — day 0, dose 1

2021-01-18

Systemic reaction (other): Itching on stomach, hands, back of legsResolved with 1 benedryl

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Slight Itching in upper arms and back on and off all day

2021-01-24

Systemic reaction (other): Felt exhausted all morning better now

Release 2 — day 7, dose 1

2021-01-25

Systemic reaction (other): Both slight

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): Runny stuffed nose scratchy throat

2021-02-14

Systemic reaction (other): Itching ( hands legs body) now and then

Release 4 — day 7, dose 2

2021-02-15

Systemic reaction (other): Mild itching on back legs

Release 5 — day 35, dose 2

2021-03-15

Symptoms: Nausea aches stomach upset diarrhea

Release 8 — 3 months, dose 2

2021-05-10

Symptoms: Bronchitis discovered in pre op check up( for cataract removal) 4/30Since medications for this ( antibiotic and steroids for lungs)have been unusually tired

Release 11 — 12 months, dose 2

2022-02-08

Symptoms: Bad cold late December lasting 10 days Shingles developed since mid January

Healthcare visit (other): PCR test from HNH

Release 12 — day 28, dose 4

2022-08-15

Symptoms: Runny nose fatigue Rapid negative

Release 12 — 3 months, dose 4

2022-10-17

Symptoms: Blood pressure elevated

Healthcare visit (other): MD visit

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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Blood pressure increased	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Herpes zoster	·	·	✓
SD	Medical counselling	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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