3SW-10059-01175

4 vaccinations 7 coded responses 33 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 333 / FL
Registered: 2021-01-13

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Pfizer-BioNTech
2021-01-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Self-medication — Feeling: Good · Site: Itching · Fever · Headache

Free text: I took Tylenol for the headache and it went away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Pfizer-BioNTech
2021-02-03
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Muscle or body aches

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Good

Free text: Constant headace

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Exposure to SARS-CoV-2, Headache, SARS-CoV-2 test — Feeling: Fair

Free text: Headache for weeks then stopped. Started 4days ago again. Got tested today for COVID due to my son tested positive Im waiting on result 3-5days time.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-04
Survey response — 12 months, dose 2
MedDRA: Adverse food reaction, Flatulence, Oral pain — Feeling: Fair

Free text: I noticed since I took the shots when I eat the fruits or nuts I get a bad reaction to them; for instant mangoes, pineapple, jackfruit grapes, ginep etc I get sore mouth and nuts I get gassed.

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Dose 3 — Pfizer-BioNTech
2022-04-23
Survey response — day 0, dose 3
MedDRA: No adverse event — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-08-23
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-08-23
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-08-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-08-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2022-08-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Nausea

Adult check-in
2022-08-28
Survey response — days 1–6 daily, dose 4
MedDRA: Ear discomfort — Feeling: Good · Headache, Nausea

Free text: Clogged ears 3different times

MedDRA releases: 2024-11 · check-in free text available
2022-08-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-08-31
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-09-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Pfizer-BioNTech
2	2021-02-03	Pfizer-BioNTech
3	2022-04-23	Pfizer-BioNTech	No
4	2022-08-23	Pfizer-BioNTech	Flu

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): I took Tylenol for the headache and it went away

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Weakness

Release 5 — day 42, dose 2

2021-03-17

Symptoms: Constant headace

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Headache for weeks then stopped. Started 4days ago again. Got tested today for COVID due to my son tested positive Im waiting on result 3-5days time.

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: I noticed since I took the shots when I eat the fruits or nuts I get a bad reaction to them; for instant mangoes, pineapple, jackfruit grapes, ginep etc I get sore mouth and nuts I get gassed.

Release 11 — day 0, dose 3

2022-04-23

Systemic reaction (other): No

Release 12 — days 1–6 daily, dose 4

2022-08-28

Systemic reaction (other): Clogged ears 3different times

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
SD	Adverse food reaction	·	·	✓
SD	Exposure to SARS-CoV-2	✓	·	✓
SD	Flatulence	·	·	✓
SD	Headache	✓	✓	✓
SD	Oral pain	·	·	✓
SD	SARS-CoV-2 test	✓	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Ear discomfort	·	·	✓
SRO	Headache	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Self-medication	✓	✓	✓

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