2EX-19065-29915

2 vaccinations 9 coded responses 27 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 498 / MI
Registered: 2021-08-13

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

2021-08-10
Dose 1 — Pfizer-BioNTech
2021-08-13
Registered in v-safe
2021-08-13
Survey response — days 1–6 daily, dose 1
MedDRA: Vaginal haemorrhage — Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Moderate Vaginal Bleeding

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-14
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms, Vaginal haemorrhage — Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Moderate Vaginal bleeding with cramping

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-15
Survey response — days 1–6 daily, dose 1
MedDRA: Vaginal haemorrhage — Feeling: Poor · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Moderate Vaginal bleeding.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-16
Survey response — days 1–6 daily, dose 1
MedDRA: Vaginal haemorrhage — Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school

Free text: Moderate vaginal bleeding

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Health check-in — day 7, dose 1
Feeling: Poor · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-08-17
Report sent to call center — day 7, dose 1
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Survey response — day 14, dose 1
MedDRA: Appendicectomy, Appendicitis — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Developed Appendicitis and had to have my appendix removed

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-24
Report sent to call center — day 14, dose 1
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)
2021-08-24
Call 1 — Left Voicemail
2021-08-30
Call 1 — Left Voicemail
2021-08-31
Survey response — day 21, dose 1
MedDRA: Diarrhoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme fatigue, diarrhea

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-07
Health check-in — day 28, dose 1
Feeling: Poor

Adult check-in
2021-09-14
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-09-21
Health check-in — day 42, dose 1
Feeling: Poor

Adult check-in
2021-11-09
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2021-11-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-02
Dose 2 — Pfizer-BioNTech
2022-03-02
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2022-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2022-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2022-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Diarrhea

Adult check-in
2022-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-03-09
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2022-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2022-03-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2022-03-30
Survey response — day 28, dose 2
MedDRA: Abdominal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: GI discomfort

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-04-13
Survey response — day 42, dose 2
MedDRA: Malaise — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid 19 symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — 3 months, dose 2
MedDRA: Brain fog, Fatigue — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue, brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-08-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2023-03-02
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-10	Pfizer-BioNTech	No
2	2022-03-02	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-17	Unsuccessful
2021-08-24	Successful 2021-11-17	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-13

Systemic reaction (other): Moderate Vaginal Bleeding

2021-08-14

Systemic reaction (other): Moderate Vaginal bleeding with cramping

2021-08-15

Systemic reaction (other): Moderate Vaginal bleeding.

2021-08-16

Systemic reaction (other): Moderate vaginal bleeding

Release 9 — day 14, dose 1

2021-08-24

Symptoms: Developed Appendicitis and had to have my appendix removed

Release 9 — day 21, dose 1

2021-08-31

Symptoms: Extreme fatigue, diarrhea

Release 11 — day 28, dose 2

2022-03-30

Symptoms: GI discomfort

Release 11 — day 42, dose 2

2022-04-13

Symptoms: Covid 19 symptoms

Release 11 — 3 months, dose 2

2022-06-01

Symptoms: Fatigue, brain fog

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	Abdominal discomfort	·	·	✓
SD	Appendicectomy	✓	·	✓
SD	Appendicitis	✓	·	✓
SD	Brain fog	·	·	✓
SD	Diarrhoea	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Malaise	·	·	✓
SRO	Muscle spasms	✓	·	✓
SRO	Vaginal haemorrhage	✓	·	✓

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