ZKA-19045-98620

2 vaccinations 10 coded responses 21 check-ins 10 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 991 / WA
Registered: 2021-03-15

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

2021-03-12
Dose 1 — Pfizer-BioNTech
2021-03-15
Registered in v-safe
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — day 14, dose 1
MedDRA: Arthralgia, Diarrhoea, Fatigue, Feeling abnormal, Myalgia — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Loose stools, fatigue, muscle and joint pain, mental fogginess

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Dose 2 — Pfizer-BioNTech
2021-04-02
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Light headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Diarrhea

Free text: Lightheadedness

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: Good · Site: Pain · Joint pains

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Survey response — day 14, dose 2
MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Continued joint pain, especially in my shoulders, which got worse until this past Wednesday (about 1.5 weeks post second shot) and is now starting to diminish. I reported no joint pain at one of last check-ins, in error.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 21, dose 2
MedDRA: Arthralgia, Diarrhoea — 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

Free text: Loose stools x 3 daysContinuing joint pain particularly in shoulders

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-30
Survey response — day 28, dose 2
MedDRA: Infection, Pain — Feeling: Fair · Be unable to work, 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: Infection in right calf. Pain requires pain medication.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Survey response — day 35, dose 2
MedDRA: Localised infection — Feeling: Fair · Be unable to work, 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: Infection in R leg progressed, requiring antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Gait disturbance — 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, Outpatient clinic or urgent care clinic visit

Free text: Pain in knee making it very difficult to walk.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — 3 months, dose 2
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)
2021-07-06
Call 1 — Left Voicemail
2021-10-01
Survey response — 6 months, dose 2
MedDRA: Breast cancer, Mastectomy, Surgery — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Diagnosed with breast cancer. Had mastectomy two days ago. · Healthcare visit (other): Surgery

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Hospitalization · 1 call case(s)
2021-10-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-02
Survey response — 12 months, dose 2
MedDRA: Concussion, Eye contusion, Fall, Nasopharyngitis, SARS-CoV-2 test negative — 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, Emergency room or emergency department visit

Free text: Severe cold tested and negative for COVID by antigen test x2 and Pcr x1; also fall resulting in a mild concussion and black eye

MedDRA releases: 2024-11 · check-in free text available
2022-04-02
Report sent to call center — 12 months, dose 2
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 · Emergency room or emergency department visit · 1 call case(s)
2022-04-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Pfizer-BioNTech
2	2021-04-02	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-23	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-04-30	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-07	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-02	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-01	Successful 2021-10-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-02	Successful 2022-04-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 6 — day 14, dose 1

2021-03-26

Symptoms: Loose stools, fatigue, muscle and joint pain, mental fogginess

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Light headedness

2021-04-05

Systemic reaction (other): Lightheadedness

Release 7 — day 14, dose 2

2021-04-16

Symptoms: Continued joint pain, especially in my shoulders, which got worse until this past Wednesday (about 1.5 weeks post second shot) and is now starting to diminish. I reported no joint pain at one of last check-ins, in error.

Release 7 — day 21, dose 2

2021-04-23

Symptoms: Loose stools x 3 daysContinuing joint pain particularly in shoulders

Release 8 — day 28, dose 2

2021-04-30

Symptoms: Infection in right calf. Pain requires pain medication.

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Infection in R leg progressed, requiring antibiotics.

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Pain in knee making it very difficult to walk.

Release 9 — 6 months, dose 2

2021-10-01

Symptoms: Diagnosed with breast cancer. Had mastectomy two days ago.

Healthcare visit (other): Surgery

Release 11 — 12 months, dose 2

2022-04-02

Symptoms: Severe cold tested and negative for COVID by antigen test x2 and Pcr x1; also fall resulting in a mild concussion and black eye

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	Surgery	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Breast cancer	·	·	✓
SD	Concussion	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Eye contusion	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	Infection	✓	✓	✓
SD	Localised infection	✓	✓	✓
SD	Mastectomy	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Dizziness	✓	✓	✓

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