2EX-16597-72930

2 vaccinations 11 coded responses 15 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 921 / CA
Registered: 2021-01-06

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-04
Dose 1 — Pfizer-BioNTech
2021-01-06
Registered in v-safe
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Good · Site: Itching · Fatigue or tiredness · Be unable to work

Free text: Sniffing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Site: Itching · Fever · Chills, Fatigue or tiredness

Free text: Dry cough

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

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · None

Adult check-in
2021-01-19
Survey response — day 14, dose 1
MedDRA: Hot flush, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: On 1/16/21, I had a hot flash and nausea. Lasted about 30 minutes. It hasnt happened again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Dose 2 — Pfizer-BioNTech
2021-02-01
Health check-in — day 7, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Survey response — day 14, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Mild sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — day 21, dose 2
MedDRA: Rash — Feeling: Fair

Free text: Rash on neck and left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 28, dose 2
MedDRA: Rash — Feeling: Fair

Free text: Mild rash on upper arm (not where injection was given) and back shoulders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 35, dose 2
MedDRA: Fatigue, Rash, Sensitive skin — Feeling: Fair

Free text: Tiredness and skin sensitivity. Breakouts of rash on back and arms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-26
Survey response — 3 months, dose 2
MedDRA: Abdominal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: About 3 weeks ago I started experiencing what felt like waves of intense vibration in left side or abdomen. Once ina while felt it in my right back shoulder. Lasts about 30 seconds. It is intensely and frightens me . Ive never experienced this bef

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-26
Survey response — 6 months, dose 2
MedDRA: Back pain, Folliculitis, Office visit, Rash, Rash pruritic, Rash vesicular — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I had a very bad rash ( started as a red bump then blister. Very itchy.) which spread all over my body. My dermatologist said it was foliculitis when it started. It very quickly spread all over my arms, legs, back the around to the front. · Healthcare visit (other): Acupuncture and chiropractic also had lower back pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-26
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)
2021-07-28
Call 1 — Left Voicemail
2021-08-03
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-01-27
Survey response — 12 months, dose 2
MedDRA: Cough, Eye pain, Lacrimation increased, Rash, SARS-CoV-2 test positive, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dry cough, itchy throat. Stinging watery eyes. .Tested positive for Covid on 1/18/22. Still have traces of rash from initial outbreak 11 months ago.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Pfizer-BioNTech
2	2021-01-25	Pfizer-BioNTech

Call center

2 call center cases

1 successful · 1 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Sniffing

2021-01-08

Systemic reaction (other): Dry cough

2021-01-09

Systemic reaction (other): Sore throat

Release 2 — day 14, dose 1

2021-01-19

Symptoms: On 1/16/21, I had a hot flash and nausea. Lasted about 30 minutes. It hasnt happened again.

Release 3 — day 14, dose 2

2021-02-09

Symptoms: Mild sore throat.

Release 4 — day 21, dose 2

2021-02-15

Symptoms: Rash on neck and left arm.

Release 4 — day 28, dose 2

2021-02-22

Symptoms: Mild rash on upper arm (not where injection was given) and back shoulders.

Release 5 — day 35, dose 2

2021-03-03

Symptoms: Tiredness and skin sensitivity. Breakouts of rash on back and arms.

Release 8 — 3 months, dose 2

2021-04-26

Symptoms: About 3 weeks ago I started experiencing what felt like waves of intense vibration in left side or abdomen. Once ina while felt it in my right back shoulder. Lasts about 30 seconds. It is intensely and frightens me . Ive never experienced this bef

Release 9 — 6 months, dose 2

2021-07-26

Symptoms: I had a very bad rash ( started as a red bump then blister. Very itchy.) which spread all over my body. My dermatologist said it was foliculitis when it started. It very quickly spread all over my arms, legs, back the around to the front.

Healthcare visit (other): Acupuncture and chiropractic also had lower back pain

Release 11 — 12 months, dose 2

2022-01-27

Symptoms: Dry cough, itchy throat. Stinging watery eyes. .Tested positive for Covid on 1/18/22. Still have traces of rash from initial outbreak 11 months ago.

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	Back pain	✓	·	✓
HCVO	Office visit	✓	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Cough	·	·	✓
SD	Eye pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Folliculitis	✓	·	✓
SD	Hot flush	✓	✓	✓
SD	Lacrimation increased	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	·	✓
SD	Rash vesicular	✓	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sensitive skin	✓	✓	✓
SD	Throat irritation	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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