48H-12759-04037

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 875 / NM
Registered: 2021-04-14

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-14
Registered in v-safe
2021-04-14
Dose 1 — Pfizer-BioNTech
2021-04-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Arm sensation little bit of itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-05
Dose 2 — Pfizer-BioNTech
2021-05-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-20
Survey response — day 14, dose 2
MedDRA: Adverse reaction, Pain, Unevaluable event, Visual impairment — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Dull pain behind my right breast-not sure if its my lung. Also my left eye has a yellow stain when I look at white paper. Generally Im not at 100% · Healthcare visit (other): Eye app. Thinking ER for chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-26
Survey response — day 21, dose 2
MedDRA: Paraesthesia, Retinal detachment — Feeling: Fair · 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: Tingling in my hands. A detached retina out of the blue. may need surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Survey response — day 28, dose 2
MedDRA: Chest pain, Office visit, Retinal detachment, Visual impairment — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Vision in left eye has a spot. Went out of state for laser surgery. Still have chest pain plan to visit heart hospital · Healthcare visit (other): Travel by plane to eye specialist for detached retina

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-16
Survey response — day 42, dose 2
MedDRA: Gait disturbance, Muscle strain, Neuropathy peripheral — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Muscles and nerves in legs and right hip strained and made walking difficult. Left eye retina MAY have leaking vein?? Checking with specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call successful
Does not wish to fill out VAERS report
2021-11-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Pfizer-BioNTech
2	2021-05-05	Pfizer-BioNTech

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-18

Systemic reaction (other): Arm sensation little bit of itching

Release 8 — day 14, dose 2

2021-05-20

Symptoms: Dull pain behind my right breast-not sure if its my lung. Also my left eye has a yellow stain when I look at white paper. Generally Im not at 100%

Healthcare visit (other): Eye app. Thinking ER for chest pain

Release 8 — day 21, dose 2

2021-05-26

Symptoms: Tingling in my hands. A detached retina out of the blue. may need surgery

Release 8 — day 28, dose 2

2021-06-02

Symptoms: Vision in left eye has a spot. Went out of state for laser surgery. Still have chest pain plan to visit heart hospital

Healthcare visit (other): Travel by plane to eye specialist for detached retina

Release 9 — day 42, dose 2

2021-06-16

Symptoms: Muscles and nerves in legs and right hip strained and made walking difficult. Left eye retina MAY have leaking vein?? Checking with specialist

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	✓	✓	✓
HCVO	Retinal detachment	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Adverse reaction	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	Muscle strain	✓	✓	✓
SD	Myalgia	○	○	○
SD	Neuralgia	○	○	○
SD	Neuropathy peripheral	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Retinal detachment	✓	✓	✓
SD	Visual impairment	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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