ZM9-19399-05693

5 vaccinations 12 coded responses 52 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 537 / WI
Registered: 2021-03-23

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

2021-03-23
Registered in v-safe
2021-03-23
Dose 1 — Pfizer-BioNTech
2021-03-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-13
Dose 2 — Pfizer-BioNTech
2021-04-13
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Good · Fatigue or tiredness

Free text: Acid reflux

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Dose 3 — Pfizer-BioNTech
2021-10-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-22
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Lymph nodes very enlarged/swollen in left armpit. Received booster in left arm. Lymph nodes very sore.

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good · Fatigue or tiredness

Free text: Still have soreness and enlarged lymph nodes in left armpit. I got my booster in left arm. My blood type is A neg if you need that

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Still have swelling in left armpit lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Still swollen lymph nodes left armpit but less now

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — day 7, dose 3
MedDRA: Nasal congestion — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Nasal Congestion /possible cold starting?

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — day 14, dose 3
MedDRA: Lower respiratory tract infection, Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Caught a head/chest cold last Tuesday just now getting over it.

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

Adult check-in
2021-11-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-30
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-28
Dose 4 — Moderna
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-30
Survey response — days 1–6 daily, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: 3 At home tests positive for Covid , PCR tomorrow

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Survey response — days 1–6 daily, dose 4
MedDRA: Nasal congestion, Sneezing — Feeling: Poor · Site: Pain · Be unable to do your normal daily activities

Free text: Sneezing and nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion, Sneezing — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congestion, sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-04
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-18
Survey response — day 21, dose 4
MedDRA: Medical counselling, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities

Free text: Tested positive again for Covid at home. Possible Paxlovid rebound according to my PCP

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-21
Dose 5 — Moderna
2022-11-27
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-12-22
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-22
Survey response — 6 months, dose 5
MedDRA: Dizziness, Dysphagia, Gastrooesophageal reflux disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-22
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-23
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	2021-03-23	Pfizer-BioNTech
2	2021-04-13	Pfizer-BioNTech
3	2021-10-19	Pfizer-BioNTech	No
4	2022-05-28	Moderna	No
5	2022-09-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-03-22	Successful 2023-03-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Acid reflux

Release 10 — days 1–6 daily, dose 3

2021-10-22

Systemic reaction (other): Lymph nodes very enlarged/swollen in left armpit. Received booster in left arm. Lymph nodes very sore.

2021-10-23

Systemic reaction (other): Still have soreness and enlarged lymph nodes in left armpit. I got my booster in left arm. My blood type is A neg if you need that

2021-10-24

Systemic reaction (other): Still have swelling in left armpit lymph nodes

2021-10-25

Systemic reaction (other): Still swollen lymph nodes left armpit but less now

Release 10 — day 7, dose 3

2021-10-26

Systemic reaction (other): Nasal Congestion /possible cold starting?

Release 10 — day 14, dose 3

2021-11-02

Symptoms: Caught a head/chest cold last Tuesday just now getting over it.

Release 11 — days 1–6 daily, dose 4

2022-05-30

Systemic reaction (other): 3 At home tests positive for Covid , PCR tomorrow

2022-05-31

Systemic reaction (other): Sneezing and nasal congestion

2022-06-01

Systemic reaction (other): Congestion, sneezing

Release 12 — day 21, dose 4

2022-06-18

Symptoms: Tested positive again for Covid at home. Possible Paxlovid rebound according to my PCP

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
SD	Dizziness	·	·	✓
SD	Dysphagia	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Medical counselling	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	SARS-CoV-2 test positive	·	·	✓
SRO	Sneezing	·	·	✓

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