ZGM-63043-20722

4 vaccinations 11 coded responses 35 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 970 / OR
Registered: 2021-03-21

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

2021-02-24
Dose 1 — Pfizer-BioNTech
2021-03-21
Registered in v-safe
2021-03-21
Dose 2 — Pfizer-BioNTech
2021-03-21
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Headache

Free text: mental fogginess

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Site: Itching · Fever · Chills, Fatigue or tiredness, Nausea, Abdominal pain

Free text: sore throat running nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-25
Survey response — day 35, dose 2
MedDRA: Pre-existing disease, Rhinorrhoea, Seasonal allergy, Sinus congestion, Sneezing — Feeling: Good

Free text: sneezing, nasal discharge, swollen sinuses. I have allergies to tree pollen. I think that is the cause. The symptoms are no different than previous years.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-22
Survey response — 3 months, dose 2
MedDRA: Eye pruritus, Rhinorrhoea, Seasonal allergy, Sneezing — Feeling: Good

Free text: Hay fever allergies. sneezing, itchy eyes, runny nose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-03
Dose 3 — Pfizer-BioNTech
2021-10-03
Survey response — day 0, dose 3
MedDRA: Rhinorrhoea — Feeling: Good · Site: Pain

Free text: running nose

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-17
Survey response — day 14, dose 3
MedDRA: Balance disorder, Oropharyngeal pain — Feeling: Good

Free text: sore throat, sense of losing balance which lasted 4 hours.

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-07
Survey response — day 35, dose 3
MedDRA: Influenza like illness — Feeling: Good · Be unable to do your normal daily activities

Free text: I had a flu shot and experienced flu like symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-02
Survey response — 3 months, dose 3
MedDRA: Fatigue, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: Good · Be unable to do your normal daily activities

Free text: sore throat, running nose. sneezing. slight fever, fatigue. COVID home test was negative

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Pfizer-BioNTech
2022-04-17
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-04-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-22
Survey response — day 42, dose 4
MedDRA: Neck pain, Paraesthesia, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: back muscles tingling. Neck pain · Healthcare visit (other): physical therapy

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-23
Call 1 — Could Not Reach Participant
2022-05-26
Call 2 — Could Not Reach Participant
2022-07-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-07
Survey response — 6 months, dose 4
MedDRA: Ear discomfort, Lymphadenopathy, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing — 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

Free text: I tested positive for COVID on 9.18.22 . symptons very sore throat, muscle aches, low grade fever, runny nose, sneezing, swallon lymph nodes, glogged ears.

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
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)
2022-10-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-08
Survey response — 12 months, dose 4
MedDRA: Arthralgia, Arthritis, X-ray of pelvis and hip abnormal — 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

MedDRA releases: 2024-11
2023-04-08
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Pfizer-BioNTech
2	2021-03-21	Pfizer-BioNTech
3	2021-10-03	Pfizer-BioNTech	No
4	2022-04-08	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-05-22	Successful 2022-10-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-07	Successful 2022-10-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-08	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-23

Systemic reaction (other): mental fogginess

2021-03-24

Systemic reaction (other): sore throat running nose

Release 7 — day 35, dose 2

2021-04-25

Symptoms: sneezing, nasal discharge, swollen sinuses. I have allergies to tree pollen. I think that is the cause. The symptoms are no different than previous years.

Release 9 — 3 months, dose 2

2021-06-22

Symptoms: Hay fever allergies. sneezing, itchy eyes, runny nose.

Release 9 — day 0, dose 3

2021-10-03

Systemic reaction (other): running nose

Release 10 — day 14, dose 3

2021-10-17

Symptoms: sore throat, sense of losing balance which lasted 4 hours.

Release 10 — day 35, dose 3

2021-11-07

Symptoms: I had a flu shot and experienced flu like symptoms

Release 10 — 3 months, dose 3

2022-01-02

Symptoms: sore throat, running nose. sneezing. slight fever, fatigue. COVID home test was negative

Release 11 — day 42, dose 4

2022-05-22

Symptoms: back muscles tingling. Neck pain

Healthcare visit (other): physical therapy

Release 12 — 6 months, dose 4

2022-10-07

Symptoms: I tested positive for COVID on 9.18.22 . symptons very sore throat, muscle aches, low grade fever, runny nose, sneezing, swallon lymph nodes, glogged ears.

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	Physiotherapy	·	·	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	·	·	✓
SD	Balance disorder	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Myalgia	·	·	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	X-ray of pelvis and hip abnormal	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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