42U-27799-48894

2 vaccinations 7 coded responses 20 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 015 / MA
Registered: 2021-02-20

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-02-19
Dose 1 — Pfizer-BioNTech
2021-02-20
Registered in v-safe
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Diabetes issues. High blood sugar

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased — Feeling: Fair · Site: Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Elevated glucose, today 400, ketones neg. able to drink water. On insulin pump, have type 1 diabetes for 42 years & stage 111A kidney disease

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

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

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — day 7, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-03-05
Survey response — day 14, dose 1
MedDRA: Blood glucose increased — Feeling: Fair · Be unable to do your normal daily activities

Free text: Elevated glucose of over 400

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Dose 2 — Pfizer-BioNTech
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose decreased, Pre-existing disease — Feeling: Fair · Site: Swelling · Fever · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Low glucose levels, type 1 diabetic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 28, dose 2
MedDRA: Pain in extremity, Self-medication — Feeling: Fair · Be unable to do your normal daily activities

Free text: L calf pain, no swelling. Have leg elevated & on heating pad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-12
Survey response — 12 months, dose 2
MedDRA: Acute kidney injury, Acute respiratory failure, Hospitalisation, Hypoxia, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Acute respiratory failure with hypoxia & acute kidney injury diagnosed at (b)(6) ER dept on 2/16/22. Admitted to hospital for IV antibiotic. Discharged into theirHome Care program until 2/23/22. Now just need 1L of O2 at night · Healthcare visit (other): My O2 was60%

MedDRA releases: 2024-11 · check-in free text available
2022-03-12
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-03-15
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Pfizer-BioNTech
2	2021-03-12	Pfizer-BioNTech

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-20

Systemic reaction (other): Diabetes issues. High blood sugar

2021-02-21

Systemic reaction (other): Elevated glucose, today 400, ketones neg. able to drink water. On insulin pump, have type 1 diabetes for 42 years & stage 111A kidney disease

Release 5 — day 14, dose 1

2021-03-05

Symptoms: Elevated glucose of over 400

Release 5 — days 1–6 daily, dose 2

2021-03-15

Systemic reaction (other): Low glucose levels, type 1 diabetic

Release 6 — day 21, dose 2

2021-04-02

Symptoms: Fatigue

Release 7 — day 28, dose 2

2021-04-09

Symptoms: L calf pain, no swelling. Have leg elevated & on heating pad

Release 11 — 12 months, dose 2

2022-03-12

Symptoms: Acute respiratory failure with hypoxia & acute kidney injury diagnosed at (b)(6) ER dept on 2/16/22. Admitted to hospital for IV antibiotic. Discharged into theirHome Care program until 2/23/22. Now just need 1L of O2 at night

Healthcare visit (other): My O2 was60%

redacted (b)(6)

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	Acute kidney injury	·	·	✓
SD	Acute respiratory failure	·	·	✓
SD	Blood glucose increased	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Hypoxia	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Self-medication	✓	✓	✓
SRO	Blood glucose decreased	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Diabetes mellitus	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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