22K-12043-63994

2 vaccinations 3 coded responses 23 check-ins 3 free-text entries 5 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 201 / VA
Registered: 2021-04-06

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-27
Dose 2 — Pfizer-BioNTech
2021-04-27
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-29
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-30
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-05-03
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-05-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-27
Survey response — 3 months, dose 2
MedDRA: Blood pressure increased, Dysarthria, Gait disturbance, Headache, Neurological symptom, Oxygen saturation decreased — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: I am having stroking like symptoms with slurred speech. I have a headache with trouble walking. It feel like there is a air pocket in the top of my head with a Halo headache below Decrease oxygen. CT scan MRI blood work blood pressure elevated. HELP

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
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)
2021-08-05
Call successful
Participant prefers to complete VAERS report online
2021-10-28
Survey response — 6 months, dose 2
MedDRA: Chest pain — Feeling: Fair · Be unable to work or attend school

Free text: Burning lungs along with chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Survey response — 12 months, dose 2
MedDRA: Asthma, COVID-19, Conversion disorder, Dyspnoea, Gait inability, Neurological symptom, Pre-existing disease, Speech disorder — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: I've been diagnosed with conversion disorder and foreign language syndrome from the COVID. It is now acerbated by my asthma. It presents like a stroke unable to breathe walk talk. I am fighting with Kaiser Permanente and Sedgwick for disability.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-03
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Pfizer-BioNTech
2	2021-04-27	Pfizer-BioNTech

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 9 — 3 months, dose 2

2021-07-27

Symptoms: I am having stroking like symptoms with slurred speech. I have a headache with trouble walking. It feel like there is a air pocket in the top of my head with a Halo headache below Decrease oxygen. CT scan MRI blood work blood pressure elevated. HELP cut off by CDC

Release 10 — 6 months, dose 2

2021-10-28

Symptoms: Burning lungs along with chest pain

Release 11 — 12 months, dose 2

2022-04-29

Symptoms: I've been diagnosed with conversion disorder and foreign language syndrome from the COVID. It is now acerbated by my asthma. It presents like a stroke unable to breathe walk talk. I am fighting with Kaiser Permanente and Sedgwick for disability.

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	Asthma	·	·	✓
SD	Blood pressure increased	✓	·	✓
SD	Chest pain	·	·	✓
SD	Conversion disorder	·	·	✓
SD	COVID-19	·	·	✓
SD	Dysarthria	✓	·	✓
SD	Dyspnoea	·	·	✓
SD	Gait disturbance	✓	·	✓
SD	Gait inability	·	·	✓
SD	Headache	✓	·	✓
SD	Neurological symptom	✓	·	✓
SD	Oxygen saturation decreased	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Speech disorder	·	·	✓

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