2H6-17491-90379

4 vaccinations 10 coded responses 26 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 871 / NM
Registered: 2021-01-12

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Pfizer-BioNTech
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Somnolence — Feeling: Fair

Free text: Groggy

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: Headache — Feeling: Good

Free text: Slight headache feels like sinus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Pfizer-BioNTech
2021-01-29
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Eye irritation — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities

Free text: Eyes Burning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Eye irritation, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Slight rash around neck and chin area: eyes continue to feel irritated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenopia — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tired eyes

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

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Blepharospasm, Eye irritation — Feeling: Good

Free text: I had an ocular reaction with 2nd dose: (eyes burning) now I have left eye twitching

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-13
Dose 3 — Pfizer-BioNTech
2022-01-31
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-20
Dose 4 — Pfizer-BioNTech
2022-04-20
Health check-in — day 0, dose 4
Feeling: Good · Site: Itching · Fever · None

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Nausea, Vomiting

Adult check-in
2022-04-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Nausea

Adult check-in
2022-04-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Nausea

Adult check-in
2022-04-24
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Poor · Nausea, Abdominal pain

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Survey response — day 7, dose 4
MedDRA: Hospitalisation — Feeling: Fair · Site: Pain, Itching · Nausea, Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Admitted into hospital care

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — day 7, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-05-18
Survey response — day 28, dose 4
MedDRA: Fibrin D dimer increased, Hospitalisation, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Was hospitalized about 3 weeks after receiving Vaccine booster: elevated d-diner no apparent reason for elevation: I have an autoimmune disorder and am concerned that there is a correlation

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Survey response — 6 months, dose 4
MedDRA: Diarrhoea, Nausea, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nausea and vomiting Diarrhea

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Pfizer-BioNTech
2	2021-01-29	Pfizer-BioNTech
3	2021-10-13	Pfizer-BioNTech	No
4	2022-04-20	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Groggy

2021-01-16

Systemic reaction (other): Slight headache feels like sinus

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Eyes Burning

2021-02-02

Systemic reaction (other): Slight rash around neck and chin area: eyes continue to feel irritated

2021-02-03

Systemic reaction (other): Tired eyes

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: I had an ocular reaction with 2nd dose: (eyes burning) now I have left eye twitching

Release 11 — days 1–6 daily, dose 4

2022-04-24

Systemic reaction (other): Dizziness

Release 11 — day 7, dose 4

2022-04-28

Healthcare visit (other): Admitted into hospital care

Release 11 — day 28, dose 4

2022-05-18

Symptoms: Was hospitalized about 3 weeks after receiving Vaccine booster: elevated d-diner no apparent reason for elevation: I have an autoimmune disorder and am concerned that there is a correlation

Release 12 — 6 months, dose 4

2022-10-19

Symptoms: Nausea and vomiting Diarrhea

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	Hospitalisation	·	·	✓
SD	Blepharospasm	✓	·	✓
SD	Diarrhoea	·	·	✓
SD	Eye irritation	✓	·	✓
SD	Fibrin D dimer increased	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Nausea	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Vomiting	·	·	✓
SRO	Asthenopia	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Eye irritation	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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