ZNU-22854-61694

5 vaccinations 8 coded responses 29 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 836 / ID
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Pfizer-BioNTech
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Yesterday afternoon my blood sugar spiked and would not come down. (I am type 1 diabetic) Even with increased insulin doses it rose to a high of 423 and was over 300 for about 12 hours. This made for a rough night. Diabetics need to be warned this can happen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Pfizer-BioNTech
2021-01-29
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Blood glucose increased, Headache, Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Swollen painful to touch area in armpit of arm where shot received. Yesterday did not receive link to respond but had headache and 12 hours of high blood sugars

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good · Site: Pain · Headache

Free text: Soreness and swelling in the armpit and collar bone area of right arm where shot was given

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Pain of skin — Feeling: Good · Headache

Free text: Tenderness in armpit and clavicle area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair

Free text: Sore throat, runny nose, cough

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-11
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2022-01-29
Survey response — 12 months, dose 2
MedDRA: Herpes zoster, Urinary tract infection — 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: UTI, shingles

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 12 months, dose 2
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)
2022-02-11
Call successful
Participant prefers to complete VAERS report online
2022-06-06
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-11-30
Dose 5 — Pfizer-BioNTech
2022-12-06
Survey response — 6 months, dose 4
MedDRA: Arthralgia, Back pain, Joint stiffness, Musculoskeletal stiffness — Feeling: Fair

Free text: Pain and stiffness in joints, mostly in fingers and back

MedDRA releases: 2024-11 · check-in free text available
2022-12-07
Health check-in — day 7, dose 5
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-12-16
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-23
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-28
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2023-01-06
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-01-13
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-03-01
Survey response — 3 months, dose 5
MedDRA: Abdominal distension, Back pain, Constipation, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-01
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-03-02
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	2021-01-08	Pfizer-BioNTech
2	2021-01-29	Pfizer-BioNTech
3	2021-10-11	Pfizer-BioNTech	Flu
4	2022-06-06	Pfizer-BioNTech	Flu
5	2022-11-30	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-29	Successful 2022-02-11	Participant prefers to complete VAERS report online
2023-03-01	Successful 2023-03-02	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Yesterday afternoon my blood sugar spiked and would not come down. (I am type 1 diabetic) Even with increased insulin doses it rose to a high of 423 and was over 300 for about 12 hours. This made for a rough night. Diabetics need to be warned this can happen.

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Swollen painful to touch area in armpit of arm where shot received. Yesterday did not receive link to respond but had headache and 12 hours of high blood sugars

2021-02-01

Systemic reaction (other): Soreness and swelling in the armpit and collar bone area of right arm where shot was given

2021-02-02

Systemic reaction (other): Tenderness in armpit and clavicle area

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Sore throat, runny nose, cough

Release 11 — 12 months, dose 2

2022-01-29

Symptoms: UTI, shingles

Release 12 — 6 months, dose 4

2022-12-06

Symptoms: Pain and stiffness in joints, mostly in fingers and back

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	Unevaluable event	·	·	✓
SD	Abdominal distension	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Constipation	·	·	✓
SD	Cough	✓	·	✓
SD	Herpes zoster	·	·	✓
SD	Joint stiffness	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Rhinorrhoea	✓	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Diabetes mellitus	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain of skin	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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