ZPL-13681-70167

3 vaccinations 12 coded responses 29 check-ins 12 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 389 / MS
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Pfizer-BioNTech
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain · Muscle or body aches

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea, Throat irritation — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Runny nose & scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-12
Dose 2 — Pfizer-BioNTech
2021-02-12
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Fair · Site: Swelling · Fever · Muscle or body aches

Adult check-in
2021-02-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-05
Survey response — day 21, dose 2
MedDRA: Pain, Pain in extremity — Feeling: Good

Free text: My left upper arm still hurts when I raise my arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 28, dose 2
MedDRA: Impaired driving ability, Injected limb mobility decreased, Injection site reaction, Limb discomfort, Pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: My left arm continues to hurt at injection site. It hurts when I raise my arm & bothers me when Im holding the steering wheel while driving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 35, dose 2
MedDRA: Myalgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: My left arm continues to ache & hurt in the deltoid muscle.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 42, dose 2
MedDRA: Fatigue, Feeling hot, Injection site pain, Neck pain, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: The pain in my left upper arm continues to get worse. It is very painful to raise my arm. The pain now extends up into the left side of my neck. My fatigue has increased & I feel feverish daily. I have a doctors appointment on Monday, March 29th fo.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — 3 months, dose 2
MedDRA: Office visit, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: My left upper arm hurts constantly..Pain is worse as the day goes by.. · Healthcare visit (other): I saw my primary care doctor & my orthopedic doctor in their offices.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Survey response — 6 months, dose 2
MedDRA: Headache, Injection site pain, Office visit, Paranasal sinus hypersecretion — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Increased sinus drainage & headache.My right arm continues to hurt at injection site. · Healthcare visit (other): Saw doctor times 3 for evaluation & treatment. Had a CT Scan of my sinuses .

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-18
Call 1 — Left Voicemail
2021-09-01
Dose 3 — Pfizer-BioNTech
2021-09-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-08
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-02
Survey response — 3 months, dose 3
MedDRA: Adverse reaction — 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: My left arm has bothered me since I got my second Covid vaccine on 02/12/21

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Report sent to call center — 3 months, dose 3
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)
2021-12-02
Call 2 — Left Voicemail
2022-03-02
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Injection site mass, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continued pain in Left lower deltoid muscle that extends into my upper shoulder. A lump remains at injection site since second vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-09-01
Survey response — 12 months, dose 3
MedDRA: Breast cancer, Chemotherapy, Mastectomy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Diagnosis of Cancer of Left Breast on March 10,2022 · Healthcare visit (other): 8 Chemo treatments from 04/05/22 - 07/12/22 , Bilateral Mastectomy on 08/19/22

MedDRA releases: 2024-11 · check-in free text available
2022-09-01
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 2 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2022-09-07
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Pfizer-BioNTech
2	2021-02-12	Pfizer-BioNTech
3	2021-09-01	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-14	Successful 2022-09-07	Participant prefers to complete VAERS report online
2021-08-13	Successful 2022-09-07	Participant prefers to complete VAERS report online
2021-12-02	Successful 2022-09-07	Participant prefers to complete VAERS report online
2022-09-01	Successful 2022-09-07	Participant prefers to complete VAERS report online

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): No

2021-01-25

Systemic reaction (other): Runny nose & scratchy throat

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Dizziness

Release 5 — day 21, dose 2

2021-03-05

Symptoms: My left upper arm still hurts when I raise my arm.

Release 5 — day 28, dose 2

2021-03-12

Symptoms: My left arm continues to hurt at injection site. It hurts when I raise my arm & bothers me when Im holding the steering wheel while driving.

Release 5 — day 35, dose 2

2021-03-19

Symptoms: My left arm continues to ache & hurt in the deltoid muscle.

Release 6 — day 42, dose 2

2021-03-26

Symptoms: The pain in my left upper arm continues to get worse. It is very painful to raise my arm. The pain now extends up into the left side of my neck. My fatigue has increased & I feel feverish daily. I have a doctors appointment on Monday, March 29th fo. cut off by CDC

Release 8 — 3 months, dose 2

2021-05-14

Symptoms: My left upper arm hurts constantly..Pain is worse as the day goes by..

Healthcare visit (other): I saw my primary care doctor & my orthopedic doctor in their offices.

Release 9 — 6 months, dose 2

2021-08-13

Symptoms: Increased sinus drainage & headache.My right arm continues to hurt at injection site.

Healthcare visit (other): Saw doctor times 3 for evaluation & treatment. Had a CT Scan of my sinuses .

Release 10 — 3 months, dose 3

2021-12-02

Symptoms: My left arm has bothered me since I got my second Covid vaccine on 02/12/21

Release 11 — 6 months, dose 3

2022-03-02

Symptoms: Continued pain in Left lower deltoid muscle that extends into my upper shoulder. A lump remains at injection site since second vaccine.

Release 12 — 12 months, dose 3

2022-09-01

Symptoms: Diagnosis of Cancer of Left Breast on March 10,2022

Healthcare visit (other): 8 Chemo treatments from 04/05/22 - 07/12/22 , Bilateral Mastectomy on 08/19/22

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	Chemotherapy	·	·	✓
HCVO	Mastectomy	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Adverse reaction	·	·	✓
SD	Arthralgia	·	·	✓
SD	Breast cancer	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	✓	·	✓
SD	Impaired driving ability	✓	✓	✓
SD	Injected limb mobility decreased	✓	✓	✓
SD	Injection site mass	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site reaction	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paranasal sinus hypersecretion	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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