ZNS-12053-97956

3 vaccinations 14 coded responses 39 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 960 / CA
Registered: 2021-08-27

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

2021-08-27
Registered in v-safe
2021-08-27
Dose 1 — Pfizer-BioNTech
2021-08-27
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-08-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-08-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-08-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-09-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-09-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-09-03
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-09-10
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school

Free text: Headache, sore throat, fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Survey response — day 21, dose 1
MedDRA: Cough, Dyspnoea, Headache, Oropharyngeal pain, Pain, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache, sore throat, sneezing, cough, Shortness of breath, body aches

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Health check-in — day 28, dose 1
Feeling: Poor

Adult check-in
2021-10-01
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-10-08
Survey response — day 42, dose 1
MedDRA: COVID-19, Immunisation reaction, Pericarditis — 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 · Emergency room or emergency department visit

Free text: Pericarditis due to covid or vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Report sent to call center — day 42, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2021-10-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-26
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2022-01-19
Dose 2 — Pfizer-BioNTech
2022-01-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Mild chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-28
Survey response — day 7, dose 2
MedDRA: Chest pain — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Nausea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Stomach pain, nausea,

MedDRA releases: 2024-11 · check-in free text available
2022-02-09
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2022-02-16
Survey response — day 28, dose 2
MedDRA: Adnexa uteri pain, Dysmenorrhoea, Herpes simplex, Ovulation pain, Pelvic pain, Pre-existing disease — Feeling: Fair

Free text: Reactivation of herpes type 1. 15 years since last breakout. And I've been having more pelvic and ovarian pain with ovulation and my period.

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2022-03-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-04-22
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-06-18
Dose 3 — Pfizer-BioNTech
2022-06-19
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-06-20
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Dyspnoea, Hyperhidrosis — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness, sob, sweating

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-06-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-06-25
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-02
Survey response — day 14, dose 3
MedDRA: Dizziness, Fatigue, Insomnia, Myalgia, Palpitations — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Insomnia, fatigue, pounding heart rate, muscle aches, dizzy.

MedDRA releases: 2024-11 · check-in free text available
2022-07-11
Survey response — day 21, dose 3
MedDRA: Anxiety, Exercise tolerance decreased, Fatigue, Insomnia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Insomnia, anxiety, decrease exercise tolerance & fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-07-18
Health check-in — day 28, dose 3
Feeling: Poor

Adult check-in
2022-07-27
Health check-in — day 35, dose 3
Feeling: Poor

Adult check-in
2022-07-30
Health check-in — day 42, dose 3
Feeling: Poor

Adult check-in
2022-09-19
Survey response — 3 months, dose 3
MedDRA: Anxiety, Insomnia, Pain in extremity — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Insomnia. Pain that come and goes in left arm. Severe anxiety

MedDRA releases: 2024-11 · check-in free text available
2023-06-18
Survey response — 12 months, dose 3
MedDRA: Chest pain, Cough, Dyspnoea — 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 · Emergency room or emergency department visit

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-27	Pfizer-BioNTech	No
2	2022-01-19	Pfizer-BioNTech	No
3	2022-06-18	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-08	Successful 2021-10-11	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 9 — day 14, dose 1

2021-09-10

Symptoms: Headache, sore throat, fatigue

Release 9 — day 21, dose 1

2021-09-17

Symptoms: Headache, sore throat, sneezing, cough, Shortness of breath, body aches

Release 10 — day 42, dose 1

2021-10-08

Symptoms: Pericarditis due to covid or vaccine

Release 11 — days 1–6 daily, dose 2

2022-01-23

Systemic reaction (other): Chest pain

2022-01-24

Systemic reaction (other): Mild chest pain

Release 11 — day 7, dose 2

2022-01-28

Systemic reaction (other): Chest pain

Release 11 — day 14, dose 2

2022-02-02

Symptoms: Stomach pain, nausea,

Release 11 — day 28, dose 2

2022-02-16

Symptoms: Reactivation of herpes type 1. 15 years since last breakout. And I've been having more pelvic and ovarian pain with ovulation and my period.

Release 12 — days 1–6 daily, dose 3

2022-06-20

Systemic reaction (other): Dizziness

2022-06-21

Systemic reaction (other): Dizziness, sob, sweating

Release 12 — day 14, dose 3

2022-07-02

Symptoms: Insomnia, fatigue, pounding heart rate, muscle aches, dizzy.

Release 12 — day 21, dose 3

2022-07-11

Symptoms: Insomnia, anxiety, decrease exercise tolerance & fatigue

Release 12 — 3 months, dose 3

2022-09-19

Symptoms: Insomnia. Pain that come and goes in left arm. Severe anxiety

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	Abdominal pain upper	·	·	✓
SD	Adnexa uteri pain	·	·	✓
SD	Anxiety	·	·	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysmenorrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Exercise tolerance decreased	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Herpes simplex	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Insomnia	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Ovulation pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Palpitations	·	·	✓
SD	Pelvic pain	·	·	✓
SD	Pericarditis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Sneezing	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Hyperhidrosis	·	·	✓

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