42E-18741-55178

2 vaccinations 9 coded responses 15 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 922 / CA
Registered: 2021-10-30

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

2021-10-10
Dose 1 — Pfizer-BioNTech
2021-10-30
Registered in v-safe
2021-10-31
Dose 2 — Pfizer-BioNTech
2021-10-31
Survey response — day 0, dose 2
MedDRA: Autoscopy, Brain fog, Flat affect — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Yeah I few like I'm in a fog , and very disconnected, kinda like I'm here but then I feel like I'm not really hear Sorta like I feel like I am out of my body ..

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dysarthria — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Slurred speech

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-03
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dyspnoea — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Yes I have a deep cough where I am unable to take a deep cleansing breath without coughing..

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Decreased appetite, Dyspnoea — Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: No appetite, cough, hard to breathe,

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-07
Survey response — day 7, dose 2
MedDRA: Pain in jaw — Feeling: Poor · Fever · Chills, Headache · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: A severe pain in my left side of my jaw..

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — day 14, dose 2
MedDRA: Asthenia, Lethargy, Pallor, Pyrexia, Tooth abscess, Toothache — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I'm very pale, I have a fever and I have the worse abscess tooth pain ever .. I'm very lethargic weak and no energy

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-11-28
Health check-in — day 28, dose 2
Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have congestion runny nose coughing and its hard for me to breathe Im also wheezing when I breathe

Adult check-in · check-in free text available
2021-12-06
Survey response — day 35, dose 2
MedDRA: Cough, Hypersensitivity, Pre-existing disease, Tooth abscess, Unevaluable event, Urinary incontinence — 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

Free text: Symptoms: I can't get ride of my constant coughing, and every time I have a cough attack I urinate, I had to start wearing depends or pads for incontinence Plus my allergies have been amplified an worse than I have ever experienced in my lifetime. · Healthcare visit (other): I called, my primary care and they didn't have any appointments until next week, I have an appointment scheduled for the 9th of December 2021 they will give me antibiotics for my abscess tooth and hopefully it will work on anything else for me .

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Report sent to call center — day 35, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-12-12
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-12-17
Call X — Could Not Reach Participant
2022-01-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-05-02
Survey response — 6 months, dose 2
MedDRA: Foreign body in respiratory tract, Productive cough — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: It seems like I have a parasite Instead of me , I coughed up around 6. separate snail worm looking things , and I have a continuing cough that lightens up for a week or so then come back to heavy duty cough..

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — 12 months, dose 2
MedDRA: Cough, Dyspnoea, Unevaluable event — Feeling: Poor · 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

Free text: Symptoms: Continuing cough, and breathing difficulties · Healthcare visit (other): Today an update with my primary care physician

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Report sent to call center — 12 months, dose 2
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)
2022-11-02
Call 1 — Could Not Reach Participant
2022-11-03
Call 2 — Could Not Reach Participant
2022-11-03
Call 1 — Could Not Reach Participant
2022-11-04
Call 3 — Could Not Reach Participant
2022-11-04
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-10	Pfizer-BioNTech	No
2	2021-10-31	Pfizer-BioNTech	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 10 — day 0, dose 2

2021-10-31

Systemic reaction (other): Yeah I few like I'm in a fog , and very disconnected, kinda like I'm here but then I feel like I'm not really hear Sorta like I feel like I am out of my body ..

Release 10 — days 1–6 daily, dose 2

2021-11-01

Systemic reaction (other): Slurred speech

2021-11-03

Systemic reaction (other): Yes I have a deep cough where I am unable to take a deep cleansing breath without coughing..

2021-11-04

Systemic reaction (other): No appetite, cough, hard to breathe,

Release 10 — day 7, dose 2

2021-11-07

Systemic reaction (other): A severe pain in my left side of my jaw..

Release 10 — day 14, dose 2

2021-11-16

Symptoms: I'm very pale, I have a fever and I have the worse abscess tooth pain ever .. I'm very lethargic weak and no energy

Release 10 — day 35, dose 2

2021-12-06

Symptoms: I can't get ride of my constant coughing, and every time I have a cough attack I urinate, I had to start wearing depends or pads for incontinence Plus my allergies have been amplified an worse than I have ever experienced in my lifetime.

Healthcare visit (other): I called, my primary care and they didn't have any appointments until next week, I have an appointment scheduled for the 9th of December 2021 they will give me antibiotics for my abscess tooth and hopefully it will work on anything else for me .

Release 11 — 6 months, dose 2

2022-05-02

Symptoms: It seems like I have a parasite Instead of me , I coughed up around 6. separate snail worm looking things , and I have a continuing cough that lightens up for a week or so then come back to heavy duty cough..

Release 12 — day 28, dose 2

2021-11-28

Symptoms: I have congestion runny nose coughing and its hard for me to breathe Im also wheezing when I breathe

Release 12 — 12 months, dose 2

2022-11-02

Symptoms: Continuing cough, and breathing difficulties

Healthcare visit (other): Today an update with my primary care physician

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	Tooth abscess	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Foreign body in respiratory tract	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Lethargy	·	·	✓
SD	Pallor	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	Tooth abscess	·	·	✓
SD	Toothache	·	·	✓
SD	Urinary incontinence	·	·	✓
SRO	Autoscopy	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Cough	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dysarthria	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Flat affect	·	·	✓
SRO	Pain in jaw	·	·	✓

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