3EB-15281-58086

2 vaccinations 9 coded responses 25 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 080 / NJ
Registered: 2021-02-13

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

2021-02-13
Registered in v-safe
2021-02-13
Dose 1 — Pfizer-BioNTech
2021-02-13
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Survey response — day 14, dose 1
MedDRA: Ear infection, Eczema, Medical counselling, Pruritus, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: From scratching eczema in ear, got ear infection, using antibiotic ear drops from last year, if not better may have to go to dr Monday but haven't been anywhere in a year except for my 1st vaccine so hope better so can stay home. Spoke with dr office · Healthcare visit (other): Call to dr office, possible dr visit on Monday if not better tomorrow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-06
Dose 2 — Pfizer-BioNTech
2021-03-06
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Slight dizziness for a short time, minutes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site induration, Injection site nodule — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hard spot at injection site on arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising, Injection site induration — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hard spot and bruise at injection site on arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Slight bruise at injection site on arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Good · Muscle or body aches

Free text: Excessive sweating probably from dysfunctional family issues!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — day 14, dose 2
MedDRA: Ear infection, Fungal infection, Office visit, Urinary tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Probably unrelated to vaccine, ear infection, UTI, and yeast infection · Healthcare visit (other): Regular in office dr visit and outpatient lab

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-04
Survey response — 6 months, dose 2
MedDRA: Chills, Lithotripsy, Office visit, Pyrexia, Ureteric obstruction, Urinary tract infection — Feeling: Fair · 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: Recently week of UTI up to 102 fever with chills, antibiotic a week from PCP since this was post op from ureter stent removal after kidney stone laser surgery when urologist only gave me 1 antibiotic pill to prevent infection instead of 1 wk

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-04
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

1 call case(s)
2021-09-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-06
Survey response — 12 months, dose 2
MedDRA: Flank pain, Haematuria, Nephrolithiasis, Office visit, Renal stone removal — Feeling: Good · 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: Kidney stones acting up due to stress from sister interfering with my supervision of parents' care since I am their med POA. Occasional flank pain & blood in urine. Surgery March 9 to laser out kidney stones dropped into right ureter/same as Aug 6. · Healthcare visit (other): In office in person visits with urologist and nephrologist

MedDRA releases: 2024-11 · check-in free text available
2022-03-06
Report sent to call center — 12 months, dose 2
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 · 1 call case(s)
2022-03-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Pfizer-BioNTech
2	2021-03-06	Pfizer-BioNTech

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-27

Symptoms: From scratching eczema in ear, got ear infection, using antibiotic ear drops from last year, if not better may have to go to dr Monday but haven't been anywhere in a year except for my 1st vaccine so hope better so can stay home. Spoke with dr office cut off by CDC

Healthcare visit (other): Call to dr office, possible dr visit on Monday if not better tomorrow.

Release 5 — day 0, dose 2

2021-03-06

Systemic reaction (other): Slight dizziness for a short time, minutes

Release 5 — days 1–6 daily, dose 2

2021-03-08

Systemic reaction (other): Hard spot at injection site on arm.

2021-03-09

Systemic reaction (other): Hard spot and bruise at injection site on arm.

2021-03-10

Systemic reaction (other): Slight bruise at injection site on arm

2021-03-12

Systemic reaction (other): Excessive sweating probably from dysfunctional family issues!

Release 6 — day 14, dose 2

2021-03-20

Symptoms: Probably unrelated to vaccine, ear infection, UTI, and yeast infection

Healthcare visit (other): Regular in office dr visit and outpatient lab

Release 9 — 6 months, dose 2

2021-09-04

Symptoms: Recently week of UTI up to 102 fever with chills, antibiotic a week from PCP since this was post op from ureter stent removal after kidney stone laser surgery when urologist only gave me 1 antibiotic pill to prevent infection instead of 1 wk

Release 11 — 12 months, dose 2

2022-03-06

Symptoms: Kidney stones acting up due to stress from sister interfering with my supervision of parents' care since I am their med POA. Occasional flank pain & blood in urine. Surgery March 9 to laser out kidney stones dropped into right ureter/same as Aug 6. cut off by CDC

Healthcare visit (other): In office in person visits with urologist and nephrologist

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Chills	✓	·	✓
SD	Ear infection	✓	✓	✓
SD	Eczema	✓	✓	✓
SD	Flank pain	·	·	✓
SD	Fungal infection	✓	✓	✓
SD	Haematuria	·	·	✓
SD	Lithotripsy	✓	·	✓
SD	Medical counselling	✓	✓	✓
SD	Nephrolithiasis	·	·	✓
SD	Office visit	✓	·	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	Renal stone removal	·	·	✓
SD	Ureteric obstruction	✓	·	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site induration	✓	✓	✓
SRO	Injection site nodule	○	✓	○

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