2S9-14356-55558

5 vaccinations 11 coded responses 19 check-ins 10 free-text entries 9 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 070 / NJ
Registered: 2021-05-05

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

2021-04-13
Dose 1 — Pfizer-BioNTech
2021-05-03
Dose 2 — Pfizer-BioNTech
2021-05-05
Registered in v-safe
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Eye pain, Musculoskeletal stiffness — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Stiff neck, pain behind eyes, no appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-06-01
Survey response — day 28, dose 2
MedDRA: Abdominal pain, Asthenopia, Automatic bladder, Nausea, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Nausea morning noon and night. Spastic bladder Lost sixteen pounds, because of nausea . Eyes tire easily. My skin looks yellow Gastro Dr ordered ultrasound of my abdomen abdomen sore at examstion ordered ondansetton four times a day · Healthcare visit (other): Primary and Gastro .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-09
Survey response — day 35, dose 2
MedDRA: Constipation, Dermatitis contact, Onychomycosis, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: White toe nail fungus. Constipated for two weeks. Interference with poison ivy innoculation. Did not have poison ivy for decades. All of the sudden, I have extreme case of poison ivy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Survey response — 3 months, dose 2
MedDRA: Bile duct stone, Breast mass, Eyelid margin crusting, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Lump left breast. Stone in bile duct (gall bladder was removed, surgeon connected duct to liver) crusty eyes · Healthcare visit (other): Office visit to primary doctor and Gastro doctor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call 3 — Left Voicemail
2021-08-13
Callback requested for
2021-11-03
Survey response — 6 months, dose 2
MedDRA: Self-medication, Transient ischaemic attack — Feeling: Fair · 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: I had TIA two times. I almost bled out from taking Motrin

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-04
Call 3 — Left Voicemail
2022-01-11
Dose 3 — Pfizer-BioNTech
2022-06-01
Dose 4 — Pfizer-BioNTech
Co-administered: Pneumonia
2022-06-24
Survey response — day 21, dose 4
MedDRA: COVID-19, Vertigo — 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 · Telehealth, virtual health, or email health consultation

Free text: I had veryigo, which I tead is a long haul symptom of Covid 19

MedDRA releases: 2024-11 · check-in free text available
2022-06-24
Report sent to call center — day 21, dose 4
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 · 1 call case(s)
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-28
Call successful
Completed over the phone
2022-06-28
Call successful
Completed over the phone
2022-06-28
Call successful
Completed over the phone
2022-06-28
Call successful
Completed over the phone
2022-06-28
Call successful
Completed over the phone
2022-06-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-06
Survey response — day 35, dose 4
MedDRA: Diarrhoea, Headache — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Diarrhea and headache for 34 hours

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 1 — Left Voicemail
2022-07-07
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-07-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-31
Survey response — 3 months, dose 4
MedDRA: Arthritis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Severe arthritis Severe reaction to shingles vaccine which was given at the same time as the flu vaccine, in CVS in (b)(6).

MedDRA releases: 2024-11 · check-in free text available
2022-08-31
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-01
Call 1 — Left Voicemail
2022-09-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-01
Call successful
Not applicable - Accidental Reporting
2022-10-04
Dose 5 — Pfizer-BioNTech
2022-10-12
Survey response — day 7, dose 5
MedDRA: Decreased appetite, Influenza like illness, Loss of personal independence in daily activities, Mobility decreased, Somnolence — Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I felt like I have the flu for a little more than 24 hours and stayed in bed. I could not perform normal activities. I did not have an appetite. I slept all day.

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-08
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-16
Survey response — day 42, dose 5
MedDRA: Cystitis, Diarrhoea, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Bladder infection and diarrhea · Healthcare visit (other): Dr. visit with my primary doctor

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-03
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-08
Survey response — 6 months, dose 5
MedDRA: Arthritis, Bone loss, Cerebral disorder, Gastrointestinal disorder, Ligament sprain, Office visit, Onychomycosis, Rectal haemorrhage, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-04-08
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-04-10
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Pfizer-BioNTech
2	2021-05-03	Pfizer-BioNTech
3	2022-01-11	Pfizer-BioNTech	No
4	2022-06-01	Pfizer-BioNTech	Pneumonia
5	2022-10-04	Pfizer-BioNTech	No

Call center

9 call center cases

9 successful

VAERS report filed, before or during a call: 6

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-05

Systemic reaction (other): Stiff neck, pain behind eyes, no appetite

Release 8 — day 28, dose 2

2021-06-01

Symptoms: Nausea morning noon and night. Spastic bladder Lost sixteen pounds, because of nausea . Eyes tire easily. My skin looks yellow Gastro Dr ordered ultrasound of my abdomen abdomen sore at examstion ordered ondansetton four times a day

Healthcare visit (other): Primary and Gastro .

Release 9 — day 35, dose 2

2021-06-09

Symptoms: White toe nail fungus. Constipated for two weeks. Interference with poison ivy innoculation. Did not have poison ivy for decades. All of the sudden, I have extreme case of poison ivy

Release 9 — 3 months, dose 2

2021-08-02

Symptoms: Lump left breast. Stone in bile duct (gall bladder was removed, surgeon connected duct to liver) crusty eyes

Healthcare visit (other): Office visit to primary doctor and Gastro doctor

Release 10 — 6 months, dose 2

2021-11-03

Symptoms: I had TIA two times. I almost bled out from taking Motrin

Release 12 — day 21, dose 4

2022-06-24

Symptoms: I had veryigo, which I tead is a long haul symptom of Covid 19

Release 12 — day 35, dose 4

2022-07-06

Symptoms: Diarrhea and headache for 34 hours

Release 12 — 3 months, dose 4

2022-08-31

Symptoms: Severe arthritis Severe reaction to shingles vaccine which was given at the same time as the flu vaccine, in CVS in (b)(6).

redacted (b)(6)

Release 12 — day 7, dose 5

2022-10-12

Systemic reaction (other): I felt like I have the flu for a little more than 24 hours and stayed in bed. I could not perform normal activities. I did not have an appetite. I slept all day.

Release 12 — day 42, dose 5

2022-11-16

Symptoms: Bladder infection and diarrhea

Healthcare visit (other): Dr. visit with my primary doctor

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	Office visit	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Arthritis	·	·	✓
SD	Asthenopia	✓	✓	✓
SD	Automatic bladder	✓	✓	✓
SD	Bile duct stone	✓	·	✓
SD	Bone loss	·	·	✓
SD	Breast mass	✓	·	✓
SD	Cerebral disorder	·	·	✓
SD	Constipation	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Cystitis	·	·	✓
SD	Dermatitis contact	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Eyelid margin crusting	✓	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Ligament sprain	·	·	✓
SD	Nausea	✓	✓	✓
SD	Onychomycosis	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rectal haemorrhage	·	·	✓
SD	Self-medication	·	·	✓
SD	Transient ischaemic attack	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vertigo	·	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Influenza like illness	·	·	✓
SRO	Loss of personal independence in daily activities	·	·	✓
SRO	Mobility decreased	·	·	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Somnolence	·	·	✓

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