3YT-13089-64546

2 vaccinations 5 coded responses 20 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 220 / VA
Registered: 2021-02-18

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

2021-02-18
Registered in v-safe
2021-02-19
Dose 1 — Pfizer-BioNTech
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have an exacerbation of a chronic autoimmune condition that my doctor thought could be triggered by the vaccine revving up my immune system

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Pfizer-BioNTech
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — day 7, dose 2
MedDRA: Injection site pain — Feeling: Good · Site: Pain, Swelling

Free text: The pain in my arm where I got the shot started 1 week after the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-10
Survey response — 3 months, dose 2
MedDRA: Fatigue, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue. I have an autoimmune disease so it may be due to that. I mentioned it because my husband is also very fatigued and he has no health problems. Do not know if it is related to the vaccine · Healthcare visit (other): Primary care md

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-30
Call successful
Does not wish to fill out VAERS report
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Hospitalisation, Sepsis — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Hospitalized for sepsis

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-13
Call 1 — Left Voicemail
2021-09-14
Call 2 — Left Voicemail
2022-03-11
Survey response — 12 months, dose 2
MedDRA: Bronchitis, Pneumonia, Respiratory symptom — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Respiratory symptoms for 1 month in January but it was not COVID. I had bronchitis that became pneumonia

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
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

Emergency room or emergency department visit · 1 call case(s)
2022-03-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Pfizer-BioNTech
2	2021-03-11	Pfizer-BioNTech

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-25

Systemic reaction (other): I have an exacerbation of a chronic autoimmune condition that my doctor thought could be triggered by the vaccine revving up my immune system

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): The pain in my arm where I got the shot started 1 week after the shot

Release 9 — 3 months, dose 2

2021-06-10

Symptoms: Fatigue. I have an autoimmune disease so it may be due to that. I mentioned it because my husband is also very fatigued and he has no health problems. Do not know if it is related to the vaccine

Healthcare visit (other): Primary care md

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Hospitalized for sepsis

Release 11 — 12 months, dose 2

2022-03-11

Symptoms: Respiratory symptoms for 1 month in January but it was not COVID. I had bronchitis that became pneumonia

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	Bronchitis	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory symptom	·	·	✓
SD	Sepsis	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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