4CT-43889-42855

3 vaccinations 7 coded responses 26 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 300 / GA
Registered: 2021-01-12

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

2021-01-11
Dose 1 — Pfizer-BioNTech
2021-01-12
Registered in v-safe
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Headache, Fatigue or tiredness

Free text: No pain except if I touch Injection site and that is not real pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza, Nasopharyngitis — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches

Free text: Good this AM 2PM feeling flu/cold symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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 — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Pfizer-BioNTech
2021-02-01
Health check-in — day 0, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal chest pain — Feeling: Good · Abdominal pain

Free text: 1AM woke with pain in right side under ribs- lasted about 1 hour about 7 AM it felt like I had been kicked in the stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Abdominal pain

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 — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-03
Survey response — 3 months, dose 2
MedDRA: Telemedicine, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Right side under ribs and stomach- I have appt in 2 wks With gastroenterologist. · Healthcare visit (other): Telehealth w MD in office appt 2 weeks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-08-14
Dose 3 — Pfizer-BioNTech
2021-09-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-16
Survey response — 3 months, dose 3
MedDRA: Flank pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still have pain on right side under ribs. Gastroenterologist ordered test and will have a colonoscopy · Healthcare visit (other): Gastroenterologist

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-17
Call successful
Participant prefers to complete VAERS report online
2022-02-13
Survey response — 6 months, dose 3
MedDRA: Abdominal pain upper, Flank pain, Office visit, Pancreatic failure — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with pancreatic and efficiency, they put me onCREON DR 36,000units x2 every time I eat anything. Going to have a colonoscopy. The pain in my stomach, side started a few hrs after my second vaccine. Doctor Insinuated unusual pancreas so fast · Healthcare visit (other): CT Contrast, at home stool sample,Office visit with Dr.

MedDRA releases: 2024-11 · check-in free text available
2022-02-13
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-16
Call successful
Participant prefers to complete VAERS report online
2022-08-14
Survey response — 12 months, dose 3
MedDRA: Abdominal pain upper, Flank pain, Pancreatic failure — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pain in right side going towards middle of stomach resulted in me having a colonoscopy and several biopsies of my colon. Diagnosis was in efficient pancreas. The co-pay on my med is over $100 so I am not taking it.

MedDRA releases: 2024-11 · check-in free text available
2022-08-14
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Pfizer-BioNTech
2	2021-02-01	Pfizer-BioNTech
3	2021-08-14	Pfizer-BioNTech	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): No pain except if I touch Injection site and that is not real pain

2021-01-14

Systemic reaction (other): Good this AM 2PM feeling flu/cold symptoms

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): 1AM woke with pain in right side under ribs- lasted about 1 hour about 7 AM it felt like I had been kicked in the stomach

Release 8 — 3 months, dose 2

2021-05-03

Symptoms: Right side under ribs and stomach- I have appt in 2 wks With gastroenterologist.

Healthcare visit (other): Telehealth w MD in office appt 2 weeks

Release 10 — 3 months, dose 3

2021-11-16

Symptoms: Still have pain on right side under ribs. Gastroenterologist ordered test and will have a colonoscopy

Healthcare visit (other): Gastroenterologist

Release 11 — 6 months, dose 3

2022-02-13

Symptoms: Diagnosed with pancreatic and efficiency, they put me onCREON DR 36,000units x2 every time I eat anything. Going to have a colonoscopy. The pain in my stomach, side started a few hrs after my second vaccine. Doctor Insinuated unusual pancreas so fast cut off by CDC

Healthcare visit (other): CT Contrast, at home stool sample,Office visit with Dr.

Release 12 — 12 months, dose 3

2022-08-14

Symptoms: Pain in right side going towards middle of stomach resulted in me having a colonoscopy and several biopsies of my colon. Diagnosis was in efficient pancreas. The co-pay on my med is over $100 so I am not taking it.

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	Telemedicine	✓	✓	✓
SD	Abdominal pain upper	·	·	✓
SD	Flank pain	·	·	✓
SD	Office visit	·	·	✓
SD	Pancreatic failure	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Influenza	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓

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