399-22261-17694

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 462 / IN
Registered: 2021-03-27

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

2021-03-24
Dose 1 — Pfizer-BioNTech
2021-03-27
Registered in v-safe
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea

Free text: These symptoms may be related to other issues I have currently.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea

Free text: I dont believe this is vax related as Ive had these issues prior to vax.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Fatigue or tiredness, Diarrhea

Free text: Due to underlying conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Fatigue or tiredness, Diarrhea

Free text: This is due to another condition

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness, Diarrhea

Free text: Due to other conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-18
Dose 2 — Pfizer-BioNTech
2021-04-18
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-30
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-18
Survey response — 3 months, dose 2
MedDRA: Fatigue, Lymphadenopathy, Office visit, Pain, Pyrexia — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Fatigue, swollen lymph nodes, sores on multiple body parts, periodic fever. · Healthcare visit (other): Family doc visit, labs

MedDRA releases: 2024-11 · check-in free text available
2021-07-18
Report sent to call center — 3 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)
2021-07-26
Call 1 — Left Voicemail
2021-10-17
Survey response — 6 months, dose 2
MedDRA: Biopsy lung abnormal, Dyspnoea, Fatigue, Laboratory test abnormal, Lymphadenectomy, Lymphadenopathy, Pain, Polycythaemia vera, Pre-existing disease, Pyrexia, Sarcoidosis, Ulcer, Vision blurred — 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: Been diagnosed with polycythemia vera and just this week with sarcoidosis (from a biopsy). Extreme fatigue, fevers, body sores, body aches, SOB, blurry vision, swollen lymph nodes, abnormal labs, etc.. NOTE: This started long before vaccinations. · Healthcare visit (other): Excision of lymph node for biopsy

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-19
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-18
Survey response — 12 months, dose 2
MedDRA: Colitis ischaemic, Hospitalisation, Nephrolithiasis, Polycythaemia, Renal stone removal, Sarcoidosis — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: DX: Polycythemia & Sarcoidosis. Hospitalized with Ischemic Colitis & stuck kidney stone in December. Just had 4th surgery for continuing to get kidney stones.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Pfizer-BioNTech
2	2021-04-18	Pfizer-BioNTech

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-27

Systemic reaction (other): These symptoms may be related to other issues I have currently.

2021-03-28

Systemic reaction (other): I dont believe this is vax related as Ive had these issues prior to vax.

2021-03-29

Systemic reaction (other): Due to underlying conditions

2021-03-30

Systemic reaction (other): This is due to another condition

Release 6 — day 7, dose 1

2021-03-31

Systemic reaction (other): Due to other conditions

Release 9 — 3 months, dose 2

2021-07-18

Symptoms: Fatigue, swollen lymph nodes, sores on multiple body parts, periodic fever.

Healthcare visit (other): Family doc visit, labs

Release 10 — 6 months, dose 2

2021-10-17

Symptoms: Been diagnosed with polycythemia vera and just this week with sarcoidosis (from a biopsy). Extreme fatigue, fevers, body sores, body aches, SOB, blurry vision, swollen lymph nodes, abnormal labs, etc.. NOTE: This started long before vaccinations.

Healthcare visit (other): Excision of lymph node for biopsy

Release 11 — 12 months, dose 2

2022-04-18

Symptoms: DX: Polycythemia & Sarcoidosis. Hospitalized with Ischemic Colitis & stuck kidney stone in December. Just had 4th surgery for continuing to get kidney stones.

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	Lymphadenectomy	·	·	✓
HCVO	Office visit	·	·	✓
SD	Biopsy lung abnormal	·	·	✓
SD	Colitis ischaemic	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Pain	·	·	✓
SD	Polycythaemia	·	·	✓
SD	Polycythaemia vera	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Renal stone removal	·	·	✓
SD	Sarcoidosis	·	·	✓
SD	Ulcer	·	·	✓
SD	Vision blurred	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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