3QK-66552-99145

1 vaccination 13 coded responses 14 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 935 / CA
Registered: 2021-04-27

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Timeline

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

2021-04-27
Registered in v-safe
2021-04-27
Dose 1 — Pfizer-BioNTech
2021-04-27
Survey response — day 0, dose 1
MedDRA: Cough, Dyspnoea, Ear discomfort, Ear pruritus, Lacrimation increased, Nasal congestion, Pre-existing disease, Rhinorrhoea, Sneezing, Throat irritation — Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme allergies! Itchy throat, ear drums. Nasal congestion & runny nose - constant sneezing and plugged up ears, watery eyes. Cough and slight breathing issues. It is currently 5 hrs post injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, Sneezing, Throat irritation — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Nasal congestion and sneezing , itchy nose, runny nose, slight itchy throat - minor cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Pruritus, Upper-airway cough syndrome — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Nasal congestion - post nasal drip - slight itchy ear drums

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus, Lacrimation increased, Nasal congestion, Nasal pruritus, Rhinorrhoea, Sneezing, Upper-airway cough syndrome — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Nasal congestion - runny nose - itchy,watery eyes. Itchy nose - post nasal drip - sneezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Fair · Fatigue or tiredness

Free text: Nasal congestion/runny nose have improved a lot since yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 1
MedDRA: Dry throat, Fatigue, Nasal dryness — Feeling: Fair · Fatigue or tiredness

Free text: Slight lingering affects from nasal/dry throat. But mainly just really tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 7, dose 1
MedDRA: Dizziness, Fatigue, Nausea, Somnolence, Unevaluable event — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Extreme fatigue/tired throughout the day - difficult getting up in the morning due to fatigue. Slight nausea with moderate to severe dizziness. I had to call my dr.s office to schedule an appointment but they cannot see me tiknb · Healthcare visit (other): Still waiting for the doctor to call

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 7, dose 1
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)
2021-05-11
Survey response — day 14, dose 1
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat - cough - nasal congestion (I've called my doctors office a few times and left messages but the doctor or a nurse still hasen't called me back).I have a phone visit with the doctor on may 28th, 2021.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 21, dose 1
MedDRA: Cough, Headache, Pain, Respiratory tract congestion, Upper-airway cough syndrome, Vision blurred — Feeling: Fair · Be unable to do your normal daily activities

Free text: My vision has been gradually getting worse - very blurry. I don't wear glasses, not even for reading - Last week I had severe chest congestion and post nasal drip which caused a few uncontrollable cough attacks - a few slight body aches & headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 28, dose 1
MedDRA: Cough, Emergency care, Office visit, Vision blurred — Feeling: Good

Free text: Nothing New, just prolonged symptoms. Slight cough and blurred vision. Visited urgent care last Sat. for check-up regarding these symptoms - meds prescribed by Dr. - Follow up appt scheduled for this Fri. - Eye exam on Sat. 5/29/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 35, dose 1
MedDRA: Cough, Vision blurred, Visual impairment — Feeling: Good

Free text: No new symptoms - still have a slight dry cough when exhaling and blurred vision. Had my eyes checked and vision is worse than prior to receiving the vaccine. I wil return for a follow-up eye exam in 2 months.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — day 42, dose 1
MedDRA: Cough, Vision blurred — Feeling: Good

Free text: I want to report that my vision seams to be improving a little. It's still somewhat blurry however. I have another eye exam in about a 45 days from today. Other symptoms appear to be returned back to normal other than a very slight lingering cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-01
Survey response — 3 months, dose 1
MedDRA: Musculoskeletal stiffness, Sensory disturbance — Feeling: Fair · Be unable to do your normal daily activities

Free text: Neck stiffness and strange nerve sensation in forehead.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-26
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2022-05-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-27	Pfizer-BioNTech

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 8 — day 0, dose 1

2021-04-27

Systemic reaction (other): Extreme allergies! Itchy throat, ear drums. Nasal congestion & runny nose - constant sneezing and plugged up ears, watery eyes. Cough and slight breathing issues. It is currently 5 hrs post injection.

Release 8 — days 1–6 daily, dose 1

2021-04-29

Systemic reaction (other): Nasal congestion and sneezing , itchy nose, runny nose, slight itchy throat - minor cough.

2021-04-30

Systemic reaction (other): Nasal congestion - post nasal drip - slight itchy ear drums

2021-05-01

Systemic reaction (other): Nasal congestion - runny nose - itchy,watery eyes. Itchy nose - post nasal drip - sneezing.

2021-05-02

Systemic reaction (other): Nasal congestion/runny nose have improved a lot since yesterday.

2021-05-03

Systemic reaction (other): Slight lingering affects from nasal/dry throat. But mainly just really tired.

Release 8 — day 7, dose 1

2021-05-04

Systemic reaction (other): Extreme fatigue/tired throughout the day - difficult getting up in the morning due to fatigue. Slight nausea with moderate to severe dizziness. I had to call my dr.s office to schedule an appointment but they cannot see me tiknb

Healthcare visit (other): Still waiting for the doctor to call

Release 8 — day 14, dose 1

2021-05-11

Symptoms: Sore throat - cough - nasal congestion (I've called my doctors office a few times and left messages but the doctor or a nurse still hasen't called me back).I have a phone visit with the doctor on may 28th, 2021.

Release 8 — day 21, dose 1

2021-05-18

Symptoms: My vision has been gradually getting worse - very blurry. I don't wear glasses, not even for reading - Last week I had severe chest congestion and post nasal drip which caused a few uncontrollable cough attacks - a few slight body aches & headaches. cut off by CDC

Release 8 — day 28, dose 1

2021-05-26

Symptoms: Nothing New, just prolonged symptoms. Slight cough and blurred vision. Visited urgent care last Sat. for check-up regarding these symptoms - meds prescribed by Dr. - Follow up appt scheduled for this Fri. - Eye exam on Sat. 5/29/21

Release 8 — day 35, dose 1

2021-06-03

Symptoms: No new symptoms - still have a slight dry cough when exhaling and blurred vision. Had my eyes checked and vision is worse than prior to receiving the vaccine. I wil return for a follow-up eye exam in 2 months.

Release 8 — day 42, dose 1

2021-06-08

Symptoms: I want to report that my vision seams to be improving a little. It's still somewhat blurry however. I have another eye exam in about a 45 days from today. Other symptoms appear to be returned back to normal other than a very slight lingering cough. cut off by CDC

Release 9 — 3 months, dose 1

2021-08-01

Symptoms: Neck stiffness and strange nerve sensation in forehead.

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	Cough	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Musculoskeletal stiffness	✓	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sensory disturbance	✓	·	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SD	Visual impairment	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry throat	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Ear pruritus	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasal dryness	✓	✓	✓
SRO	Nasal pruritus	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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