3F8-18369-52311

5 vaccinations 10 coded responses 25 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 988 / WA
Registered: 2021-02-09

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

2021-01-20
Dose 1 — Pfizer-BioNTech
2021-02-09
Registered in v-safe
2021-02-09
Dose 2 — Pfizer-BioNTech
2021-02-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Diplopia — Feeling: Good · Site: Pain

Free text: Couple of minutes Of double vision. Dont know if it is related or not. Never experienced before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Fatigue, Musculoskeletal stiffness, Somnolence — Feeling: Fair

Free text: Stiff neck, tired, sometimes weak. Wanted to sleep more

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Arthritis — Feeling: Good · Site: Pain

Free text: Arthritis feeling L hand.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-16
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: L arm ached yesterday for several hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 14, dose 2
MedDRA: Muscle spasms, Pain in extremity — Feeling: Good

Free text: Wired deep sharp pain in L arm. Followed about 2 days later with same, deep sharp almost cramping but quite severe pain beneath the triceps. Maybe not related. Occurred when arm pressed to side. Came & went over 2 days. Maybe unrelated but new s/s.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Emergency care, Palpitations, Tachycardia — Feeling: Good

Free text: I had some heart palpitations. I was on keto diet so may have been coincidental. However my s o who is healthy had an emergency room visit with tachycardia. Also was post vaccine

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-15
Dose 3 — Pfizer-BioNTech
2022-02-15
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Pfizer-BioNTech
2022-04-21
Survey response — days 1–6 daily, dose 4
MedDRA: Pain — Feeling: Fair

Free text: Severe pain behind l ear. Comes and goes

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Survey response — day 7, dose 4
MedDRA: Tachycardia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had tachycardia with exercise that slowed to 100! When I sat down. But this is not normal for me. Rate is normally 70 to 75.

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-18
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-30
Dose 5 — Pfizer-BioNTech
2022-10-14
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-28
Survey response — day 28, dose 5
MedDRA: Blood pressure increased, Ventricular extrasystoles — Feeling: Good

Free text: Had a couple of days with PVCs. BP higher

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-30
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-31
Survey response — 6 months, dose 5
MedDRA: COVID-19, Unevaluable event — 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

MedDRA releases: 2024-11
2023-03-31
Report sent to call center — 6 months, dose 5
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 · 1 call case(s)
2023-04-03
Call 1 — Requested Callback
2023-04-03
Callback requested for
07:00PM ET
2023-04-03
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Pfizer-BioNTech
2	2021-02-09	Pfizer-BioNTech
3	2021-09-15	Pfizer-BioNTech	No
4	2022-04-15	Pfizer-BioNTech	No
5	2022-09-30	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Couple of minutes Of double vision. Dont know if it is related or not. Never experienced before.

2021-02-11

Systemic reaction (other): Stiff neck, tired, sometimes weak. Wanted to sleep more

2021-02-12

Systemic reaction (other): Arthritis feeling L hand.

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): L arm ached yesterday for several hours

Release 4 — day 14, dose 2

2021-02-24

Symptoms: Wired deep sharp pain in L arm. Followed about 2 days later with same, deep sharp almost cramping but quite severe pain beneath the triceps. Maybe not related. Occurred when arm pressed to side. Came & went over 2 days. Maybe unrelated but new s/s. cut off by CDC

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: I had some heart palpitations. I was on keto diet so may have been coincidental. However my s o who is healthy had an emergency room visit with tachycardia. Also was post vaccine

Release 11 — days 1–6 daily, dose 4

2022-04-21

Systemic reaction (other): Severe pain behind l ear. Comes and goes

Release 11 — day 7, dose 4

2022-04-24

Systemic reaction (other): Had tachycardia with exercise that slowed to 100! When I sat down. But this is not normal for me. Rate is normally 70 to 75.

Release 12 — day 28, dose 5

2022-10-28

Symptoms: Had a couple of days with PVCs. BP higher

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	Unevaluable event	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	COVID-19	·	·	✓
SD	Emergency care	✓	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	✓	·	✓
SD	Tachycardia	✓	·	✓
SD	Ventricular extrasystoles	·	·	✓
SRO	Arthritis	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Diplopia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tachycardia	·	·	✓

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