2VB-14612-99586

2 vaccinations 11 coded responses 14 check-ins 11 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 945 / CA
Registered: 2021-02-09

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-05
Dose 1 — Pfizer-BioNTech
2021-02-09
Registered in v-safe
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Disturbance in attention — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain · Be unable to work

Free text: Difficulty concentrating and decision making very slow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-22
Dose 2 — Pfizer-BioNTech
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Ankle fracture, Cardiovascular evaluation, Chills, Dizziness, Emergency care, Fall, Immediate post-injection reaction, Loss of consciousness, Pyrexia, Vaccine positive rechallenge — Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): On 2/24/2021 I lost consciousness and fell breaking my ankle. The hospital is doing tests to rule out heart issues as cause of dizziness/blackout. So far echocardiogram, ultrasound of carotid artery and heart monitoring have been normal. I experienced extreme dizziness at the first shot for 1.5 hours and mild dizziness for 2 more hours. For the second shot I experienced intermittent dizziness with fever and chills. It is possible the source of my fall was my bodies reaction to my second covid shot · Healthcare visit (other): I went into emergency on 3/24 and am leaving with broken ankle on 3/25.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — days 1–6 daily, 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)
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Emergency care, Medical counselling — Feeling: Poor · Fatigue or tiredness · 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: Systemic reaction (other): Very dizzy last night coming home from hospital. Dizziness Would not go away. · Healthcare visit (other): Last night called doctor who recommended I go to sleep, take electrolyte drink and eat light. Go to do it in the morning if it persists.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Report sent to call center — days 1–6 daily, 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)
2021-03-01
Survey response — day 7, dose 2
MedDRA: Computerised tomogram head abnormal, Emergency care, Headache, Magnetic resonance imaging head abnormal, Metamorphopsia, Pain, Transient ischaemic attack — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: On Sunday had kaleidoscope vision and pain radiating up the back of the head. Went to emergency to be evaluated for stroke. Mri and ct scan with contrast suspect a mini stroke

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — day 14, dose 2
MedDRA: Dizziness, Joint swelling, Peripheral swelling — Feeling: Poor · 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: Swelling of the left foot and ankle. Elevation of the foot does not reduce swelling. Light headed ness and dizziness upon walking.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 14, 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)
2021-03-16
Survey response — day 21, dose 2
MedDRA: Dizziness — Feeling: Poor · 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

Free text: Lightheaded predominant over the past 3 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 21, 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)
2021-03-22
Survey response — day 28, dose 2
MedDRA: Dizziness, Fall — Feeling: Poor · 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: For the past week I have experienced 3 consecutive days of lightheadedness. That is two weeks in a row of 3 consecutive days of lightheadedness. Concerned of falling again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
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)
2021-03-29
Survey response — day 35, dose 2
MedDRA: Dizziness, Presyncope — 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: Nearly blacked out on Saturday. Light headed for over 5 hours Friday, Saturday and Sunday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
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)
2021-04-05
Survey response — day 42, dose 2
MedDRA: Vertigo — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Yesterday I was watching someone change a lightbulb and got vertigo. Had to sit down because the room was spinning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — 3 months, dose 2
MedDRA: Dizziness, Eye pain, Seizure — Feeling: Poor · 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

Free text: Continued to experience lightheadedness. I received eeg. Neurologist Diagnosed with seizures. Occur every minute. Considered rare. Also pain in area of left eyes socket.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Report sent to call center — 3 months, 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)
2021-08-23
Survey response — 6 months, dose 2
MedDRA: Abdominal distension, Altered state of consciousness, Balance disorder, Dizziness, Electroencephalogram abnormal, Fatigue, Hyperresponsive to stimuli, Office visit, Post concussion syndrome, Somnolence — 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

Free text: UCSF eeg taken by(b)(6), Neurologist, diagnosed my symptoms as post concussion. Symptoms are change in balance, lightheadedness bloating, severe sleepiness, fatigue and decreased awareness or responsiveness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-23
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)
2021-08-24
Call 1 — Left Voicemail
2021-09-08
Call 2 — Left Voicemail
2021-10-21
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-02-22
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Pfizer-BioNTech
2	2021-02-22	Pfizer-BioNTech

Call center

8 call center cases

5 successful · 3 unsuccessful

VAERS report filed, before or during a call: 8

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Difficulty concentrating and decision making very slow

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): On 2/24/2021 I lost consciousness and fell breaking my ankle. The hospital is doing tests to rule out heart issues as cause of dizziness/blackout. So far echocardiogram, ultrasound of carotid artery and heart monitoring have been normal. I experienced extreme dizziness at the first shot for 1.5 hours and mild dizziness for 2 more hours. For the second shot I experienced intermittent dizziness with fever and chills. It is possible the source of my fall was my bodies reaction to my second covid shot

Healthcare visit (other): I went into emergency on 3/24 and am leaving with broken ankle on 3/25.

2021-02-27

Systemic reaction (other): Very dizzy last night coming home from hospital. Dizziness Would not go away.

Healthcare visit (other): Last night called doctor who recommended I go to sleep, take electrolyte drink and eat light. Go to do it in the morning if it persists.

Release 4 — day 7, dose 2

2021-03-01

Systemic reaction (other): On Sunday had kaleidoscope vision and pain radiating up the back of the head. Went to emergency to be evaluated for stroke. Mri and ct scan with contrast suspect a mini stroke

Release 5 — day 14, dose 2

2021-03-08

Symptoms: Swelling of the left foot and ankle. Elevation of the foot does not reduce swelling. Light headed ness and dizziness upon walking.

Release 5 — day 21, dose 2

2021-03-16

Symptoms: Lightheaded predominant over the past 3 days

Release 6 — day 28, dose 2

2021-03-22

Symptoms: For the past week I have experienced 3 consecutive days of lightheadedness. That is two weeks in a row of 3 consecutive days of lightheadedness. Concerned of falling again.

Release 6 — day 35, dose 2

2021-03-29

Symptoms: Nearly blacked out on Saturday. Light headed for over 5 hours Friday, Saturday and Sunday.

Release 6 — day 42, dose 2

2021-04-05

Symptoms: Yesterday I was watching someone change a lightbulb and got vertigo. Had to sit down because the room was spinning.

Release 8 — 3 months, dose 2

2021-05-24

Symptoms: Continued to experience lightheadedness. I received eeg. Neurologist Diagnosed with seizures. Occur every minute. Considered rare. Also pain in area of left eyes socket.

Release 9 — 6 months, dose 2

2021-08-23

Symptoms: UCSF eeg taken by(b)(6), Neurologist, diagnosed my symptoms as post concussion. Symptoms are change in balance, lightheadedness bloating, severe sleepiness, fatigue and decreased awareness or responsiveness

redacted (b)(6)

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	Ankle fracture	✓	✓	✓
HCVO	Emergency care	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
SD	Abdominal distension	✓	·	✓
SD	Altered state of consciousness	✓	·	✓
SD	Balance disorder	✓	·	✓
SD	Dizziness	✓	✓	✓
SD	Electroencephalogram abnormal	✓	·	✓
SD	Eye pain	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Hyperresponsive to stimuli	✓	·	✓
SD	Joint swelling	✓	✓	✓
SD	Office visit	✓	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Post concussion syndrome	✓	·	✓
SD	Presyncope	✓	·	✓
SD	Seizure	✓	✓	✓
SD	Somnolence	✓	·	✓
SD	Vertigo	✓	✓	✓
SRO	Ankle fracture	✓	✓	✓
SRO	Cardiovascular evaluation	○	✓	○
SRO	Chills	✓	✓	✓
SRO	Computerised tomogram head	○	○	○
SRO	Computerised tomogram head abnormal	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓
SRO	Magnetic resonance imaging head abnormal	✓	✓	✓
SRO	Metamorphopsia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Transient ischaemic attack	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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