4JM-26914-69276

3 vaccinations 15 coded responses 31 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 260 / WV
Registered: 2021-03-07

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

2021-03-05
Dose 1 — Pfizer-BioNTech
2021-03-07
Registered in v-safe
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Symptoms are probably related to Afib flare up from prior to vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Atrial fibrillation, Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Fatigue from Afib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pre-existing disease — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Fatigue from afib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Atrial fibrillation — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Afib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 7, dose 1
MedDRA: Atrial fibrillation — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Afib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-26
Dose 2 — Pfizer-BioNTech
2021-03-26
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: A fib has been active for last month

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Fair · Fatigue or tiredness

Free text: I relate this to Afib flare of symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness

Free text: Believe it is related to afib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Relate to Afib and medications

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Related To Afib and medications

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 7, dose 2
MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Believe related to AFIB flare

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

Adult check-in
2021-04-16
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 42, dose 2
MedDRA: Patella fracture, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Broken knee cap and waiting for transfer to SkiD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Arthritis infective, Atrial fibrillation, Knee operation, Lower limb fracture, Medical counselling, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Fractured left knee cap, knee infection, three knee surgeries, recurrence of Afib · Healthcare visit (other): Skilled care facility

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Report sent to call center — 6 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-09-28
Call 1 — Left Voicemail
2021-10-04
Dose 3 — Pfizer-BioNTech
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-11
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-08
Survey response — day 35, dose 3
MedDRA: Nasopharyngitis, Sneezing — Feeling: Good

Free text: Cold with sneezes

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-04
Survey response — 12 months, dose 3
MedDRA: Atrial fibrillation, COVID-19, Medical procedure — Feeling: Good · 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, Hospitalization

Free text: Symptoms: Heart Afib diagnosed prior to covid · Healthcare visit (other): Ablation

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Report sent to call center — 12 months, dose 3
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 · Hospitalization · 1 call case(s)
2022-10-06
Call 2 — Left Voicemail
2022-10-06
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Pfizer-BioNTech
2	2021-03-26	Pfizer-BioNTech
3	2021-10-04	Pfizer-BioNTech	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-08

Systemic reaction (other): Symptoms are probably related to Afib flare up from prior to vaccine

2021-03-09

Systemic reaction (other): Fatigue from Afib

2021-03-10

Systemic reaction (other): Fatigue from afib

2021-03-11

Systemic reaction (other): Afib

Release 5 — day 7, dose 1

2021-03-12

Systemic reaction (other): Afib

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): A fib has been active for last month

2021-03-29

Systemic reaction (other): I relate this to Afib flare of symptoms

2021-03-30

Systemic reaction (other): Believe it is related to afib

2021-03-31

Systemic reaction (other): Relate to Afib and medications

2021-04-01

Systemic reaction (other): Related To Afib and medications

Release 6 — day 7, dose 2

2021-04-02

Systemic reaction (other): Believe related to AFIB flare

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Broken knee cap and waiting for transfer to SkiD

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: Fractured left knee cap, knee infection, three knee surgeries, recurrence of Afib

Healthcare visit (other): Skilled care facility

Release 10 — day 35, dose 3

2021-11-08

Symptoms: Cold with sneezes

Release 12 — 12 months, dose 3

2022-10-04

Symptoms: Heart Afib diagnosed prior to covid

Healthcare visit (other): Ablation

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	Medical counselling	·	·	✓
HCVO	Medical procedure	·	·	✓
SD	Arthritis infective	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	COVID-19	·	·	✓
SD	Knee operation	·	·	✓
SD	Lower limb fracture	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Patella fracture	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sneezing	·	·	✓
SRO	Atrial fibrillation	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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