ZQY-13474-03223

3 vaccinations 10 coded responses 34 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 967 / HI
Registered: 2021-01-14

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

2021-01-13
Dose 1 — Pfizer-BioNTech
2021-01-14
Registered in v-safe
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Injection site pain — Feeling: Good · Site: Pain, Swelling

Free text: Had 1Â bruise at injection site that started hurting 7 hours after injection but pain subsided next day after exercise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Happiness :)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Injection site pain — Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness

Free text: Still have bruise at injection site thats what hurt fir a day after injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Free text: Feel ok otherwise weather rainy could be sinus infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Pfizer-BioNTech
2021-02-03
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness · Be unable to work

Free text: On amoxicillin for sinus condition and possible UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Finished Amoxicillin today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity — Feeling: Good

Free text: Nasal allergies due to pollen from blooming trees and humid rainy weather

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Diarrhoea, Gastrointestinal infection, Office visit — Feeling: Good · Be unable to work or attend school, 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: Diarrhea and intestinal infection which might be due to diverticulosis seeing an allergy doctor and referred for colonoscopy and or endoscopy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
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

1 call case(s)
2021-08-14
Call 1 — Left Voicemail
2021-11-16
Dose 3 — Pfizer-BioNTech
2021-11-18
Survey response — days 1–6 daily, dose 3
MedDRA: Headache, Impaired work ability, Influenza like illness, Injection site pain, Loss of personal independence in daily activities — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Evening after vax and all next day had flu like symptoms headache and pain at injection site which limited my activities and couldn't have worked the day after

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-22
Survey response — days 1–6 daily, dose 3
MedDRA: Somnolence, Stress — Feeling: Good · Be unable to do your normal daily activities

Free text: Sleepy, took nap but probably due to work schedule, stress

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-18
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Pfizer-BioNTech
2	2021-02-03	Pfizer-BioNTech
3	2021-11-16	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-04	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Had 1Â bruise at injection site that started hurting 7 hours after injection but pain subsided next day after exercise

2021-01-16

Systemic reaction (other): Happiness :)

2021-01-17

Systemic reaction (other): Still have bruise at injection site thats what hurt fir a day after injection

2021-01-18

Systemic reaction (other): Feel ok otherwise weather rainy could be sinus infection

Release 3 — day 0, dose 2

2021-02-03

Systemic reaction (other): On amoxicillin for sinus condition and possible UTI

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Finished Amoxicillin today

Release 8 — 3 months, dose 2

2021-05-07

Symptoms: Nasal allergies due to pollen from blooming trees and humid rainy weather

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Diarrhea and intestinal infection which might be due to diverticulosis seeing an allergy doctor and referred for colonoscopy and or endoscopy

Release 10 — days 1–6 daily, dose 3

2021-11-18

Systemic reaction (other): Evening after vax and all next day had flu like symptoms headache and pain at injection site which limited my activities and couldn't have worked the day after

2021-11-22

Systemic reaction (other): Sleepy, took nap but probably due to work schedule, stress

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	Diarrhoea	✓	·	✓
SD	Gastrointestinal infection	✓	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Office visit	✓	·	✓
SRO	Headache	·	·	✓
SRO	Impaired work ability	·	·	✓
SRO	Influenza like illness	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Loss of personal independence in daily activities	·	·	✓
SRO	Somnolence	·	·	✓
SRO	Stress	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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