ZFA-10771-90921

4 vaccinations 8 coded responses 41 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 873 / NM
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 · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Pfizer-BioNTech
2021-02-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Depression, Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Woke up feeling fatigued and depressed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Myalgia, Tendon pain — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Right shoulder rotator cuff pain. Dont know if its related to vaccine or not.

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: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 28, dose 2
MedDRA: Office visit, Rotator cuff syndrome — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Injured rotator cuff right shoulder · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Survey response — day 35, dose 2
MedDRA: Arthralgia, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe right rotator cuff pain · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
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: Good

Adult check-in
2021-09-25
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-01
Survey response — days 1–6 daily, dose 3
MedDRA: Musculoskeletal stiffness — Feeling: Good · Muscle or body aches

Free text: Stiffness but not sure if its vaccine related.

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-09
Survey response — day 14, dose 3
MedDRA: Office visit, Tooth abscess — Feeling: Good · 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: Symptoms: An abscessed tooth requiring a root canal · Healthcare visit (other): Dentist and Endodontist

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-12
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-31
Dose 4 — Pfizer-BioNTech
2022-04-14
Survey response — day 14, dose 4
MedDRA: Emergency care, Office visit, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I broke out in rash head to toe on April 11, went to ER on April 12 and saw primary care doctor on April 14. Rash is slowly going away. We are reasonably sure that it was a result of starting a new healthcare product which I've now stopped.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Report sent to call center — day 14, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-02
Survey response — 12 months, dose 4
MedDRA: Fatigue, Insomnia, 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

MedDRA releases: 2024-11
2023-04-02
Report sent to call center — 12 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)
2023-04-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Pfizer-BioNTech
2	2021-02-19	Pfizer-BioNTech
3	2021-09-25	Pfizer-BioNTech	Flu
4	2022-03-31	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-19	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-27	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-09	Successful 2021-10-12	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-14	Successful 2022-04-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-02	Successful 2023-04-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): Woke up feeling fatigued and depressed.

2021-02-23

Systemic reaction (other): Right shoulder rotator cuff pain. Dont know if its related to vaccine or not.

Release 5 — day 28, dose 2

2021-03-19

Symptoms: Injured rotator cuff right shoulder

Healthcare visit (other): Physical therapy

Release 6 — day 35, dose 2

2021-03-27

Symptoms: Severe right rotator cuff pain

Healthcare visit (other): Physical therapy

Release 9 — days 1–6 daily, dose 3

2021-10-01

Systemic reaction (other): Stiffness but not sure if its vaccine related.

Release 10 — day 14, dose 3

2021-10-09

Symptoms: An abscessed tooth requiring a root canal

Healthcare visit (other): Dentist and Endodontist

Release 11 — day 14, dose 4

2022-04-14

Symptoms: I broke out in rash head to toe on April 11, went to ER on April 12 and saw primary care doctor on April 14. Rash is slowly going away. We are reasonably sure that it was a result of starting a new healthcare product which I've now stopped.

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	Physiotherapy	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Insomnia	·	·	✓
SD	Office visit	·	·	✓
SD	Rash	·	·	✓
SD	Rotator cuff syndrome	✓	✓	✓
SD	Tooth abscess	·	·	✓
SRO	Depression	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Musculoskeletal stiffness	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Tendon pain	✓	✓	✓

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