3JX-58604-95878

2 vaccinations 12 coded responses 22 check-ins 12 free-text entries 3 call cases

Sex: —
Age at first dose: 66+
ZIP prefix: 750 / TX
Registered: 2021-02-08

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

2021-02-08
Registered in v-safe
2021-02-08
Dose 1 — Pfizer-BioNTech
2021-02-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling

Free text: Had asthma attack last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Bronchitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-02-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-08
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-03-12
Dose 2 — Pfizer-BioNTech
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal distension — Feeling: Poor · Site: Pain · Fever · Be unable to do your normal daily activities

Free text: Extreme swelling on left side of abdomen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Abdominal pain · Be unable to do your normal daily activities

Free text: Pin in left quadrant just below riba

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Site: Swelling · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Specific pain in left quadrant under ribs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea, Pain, Swelling — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache · Be unable to do your normal daily activities

Free text: Swelled left side, pain & nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 7, dose 2
MedDRA: Pain, Swelling — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain & swelling left quadrant, maybe liver.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 28, dose 2
MedDRA: Induration, Musculoskeletal stiffness, Pain, Swelling — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Severe pain in mid area left side as well as swelling & stiff, hardened area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 35, dose 2
MedDRA: Office visit, Pain, Swelling — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe pain & swelling in midline area. Dr. Prescribed a CT Scan 04/19/21. Becoming concerning · Healthcare visit (other): Dr. In office consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Health check-in — day 42, dose 2
Feeling: Poor

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Have no stamina & some brain issues as well as shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-21
Call successful
Completed over the phone
2021-09-10
Survey response — 6 months, dose 2
MedDRA: Abdominal distension, Arthralgia, Epstein-Barr virus test positive — Feeling: Poor · 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: Severe joint pain. Swelled left abdominal area. Epstein Barr virus. Positive.

MedDRA releases: 2024-11 · check-in free text available
2021-09-10
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)
2021-09-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Pfizer-BioNTech
2	2021-03-12	Pfizer-BioNTech

Call center

3 call center cases

2 successful · 1 unsuccessful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Had asthma attack last night

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Bronchitis

Release 5 — days 1–6 daily, dose 2

2021-03-15

Systemic reaction (other): Extreme swelling on left side of abdomen

2021-03-16

Systemic reaction (other): Pin in left quadrant just below riba

2021-03-17

Systemic reaction (other): Specific pain in left quadrant under ribs

2021-03-18

Systemic reaction (other): Swelled left side, pain & nausea

Release 5 — day 7, dose 2

2021-03-19

Systemic reaction (other): Pain & swelling left quadrant, maybe liver.

Release 7 — day 21, dose 2

2021-04-05

Symptoms: Severe exhaustion

Release 7 — day 28, dose 2

2021-04-09

Symptoms: Severe pain in mid area left side as well as swelling & stiff, hardened area.

Release 7 — day 35, dose 2

2021-04-16

Symptoms: Severe pain & swelling in midline area. Dr. Prescribed a CT Scan 04/19/21. Becoming concerning

Healthcare visit (other): Dr. In office consultation

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: Have no stamina & some brain issues as well as shortness of breath

Release 9 — 6 months, dose 2

2021-09-10

Symptoms: Severe joint pain. Swelled left abdominal area. Epstein Barr virus. Positive.

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 distension	·	·	✓
SD	Arthralgia	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Epstein-Barr virus test positive	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Induration	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Swelling	✓	✓	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Asthma	✓	✓	✓
SRO	Bronchitis	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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