4MH-10195-58218

5 vaccinations 14 coded responses 47 check-ins 13 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 802 / CO
Registered: 2021-01-31

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

2021-01-31
Registered in v-safe
2021-01-31
Dose 1 — Pfizer-BioNTech
2021-01-31
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea — Feeling: Good · Diarrhea

Free text: I think it is food born diarrhea. Bad fries at Macdonalds. Tasted odd

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-07
Health check-in — day 7, dose 1
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-02-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-21
Dose 2 — Pfizer-BioNTech
2021-02-21
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Survey response — day 14, dose 2
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarrhea pretty bad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — day 21, dose 2
MedDRA: Diarrhoea, Self-medication — Feeling: Poor

Free text: Some diarrhea most of the week. Hav e been on BRAT type diet but added some other foods yesterday at dinner So had a Terrible morning ! Too much snow to go to doctor. Back on strict diet :-( Am taking some acidolphalus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — day 28, dose 2
MedDRA: Diarrhoea, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diarrhea · Healthcare visit (other): Have to schedule calling tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Survey response — day 35, dose 2
MedDRA: Diarrhoea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diarrhea · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-22
Survey response — 6 months, dose 2
MedDRA: Dry eye, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe dry eye. Going to see eye doc tomorrow. Terrible air quality and using a mask probably didnt help · Healthcare visit (other): Going tomorrow to dr office

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-22
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Call 1 — Left Voicemail
2021-08-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-24
Dose 3 — Pfizer-BioNTech
2021-09-30
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site erythema, Injection site pain, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling · Diarrhea

Free text: The pain redness and swelling was at injections site lasting only first 3days. Nothing now .

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-08
Survey response — day 14, dose 3
MedDRA: Diarrhoea, Self-medication, Vaccine positive rechallenge — Feeling: Fair

Free text: Diarrhea for 3 days treating with Imodium. Continues, but not severe now. I had the same reaction to second Pfizer, it does not start till 7- 10 days after shot

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-24
Survey response — 3 months, dose 3
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-03-27
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-31
Dose 4 — Moderna
2022-04-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-13
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-29
Survey response — 6 months, dose 4
MedDRA: Basal cell carcinoma, Micrographic skin surgery, Skin cancer — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Basel cell skin camcers · Healthcare visit (other): Mohs surgery

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Survey response — day 14, dose 5
MedDRA: Basal cell carcinoma — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Skin cancer basal

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Report sent to call center — day 14, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-29
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-30
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-30
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-04
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-11
Survey response — day 28, dose 5
MedDRA: Nausea — Feeling: Poor

Free text: Persistent nausea

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Survey response — day 35, dose 5
MedDRA: Nausea — Feeling: Fair

Free text: Still have constant nausea.

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-13
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-14
Survey response — 6 months, dose 5
MedDRA: Back pain, Sciatica — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-31	Pfizer-BioNTech
2	2021-02-21	Pfizer-BioNTech
3	2021-09-24	Pfizer-BioNTech	No
4	2022-03-31	Moderna	No
5	2022-09-13	Pfizer-BioNTech	Flu

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I think it is food born diarrhea. Bad fries at Macdonalds. Tasted odd

Release 5 — day 14, dose 2

2021-03-07

Symptoms: Diarrhea pretty bad

Release 5 — day 21, dose 2

2021-03-14

Symptoms: Some diarrhea most of the week. Hav e been on BRAT type diet but added some other foods yesterday at dinner So had a Terrible morning ! Too much snow to go to doctor. Back on strict diet :-( Am taking some acidolphalus

Release 6 — day 28, dose 2

2021-03-21

Symptoms: Diarrhea

Healthcare visit (other): Have to schedule calling tomorrow

Release 6 — day 35, dose 2

2021-03-28

Symptoms: Diarrhea

Healthcare visit (other): Doctors office

Release 9 — 6 months, dose 2

2021-08-22

Symptoms: Severe dry eye. Going to see eye doc tomorrow. Terrible air quality and using a mask probably didnt help

Healthcare visit (other): Going tomorrow to dr office

Release 9 — days 1–6 daily, dose 3

2021-09-30

Systemic reaction (other): The pain redness and swelling was at injections site lasting only first 3days. Nothing now .

Release 10 — day 14, dose 3

2021-10-08

Symptoms: Diarrhea for 3 days treating with Imodium. Continues, but not severe now. I had the same reaction to second Pfizer, it does not start till 7- 10 days after shot

Release 10 — 3 months, dose 3

2021-12-24

Symptoms: Diarrhea

Release 12 — 6 months, dose 4

2022-09-29

Symptoms: Basel cell skin camcers

Healthcare visit (other): Mohs surgery

Release 12 — day 14, dose 5

2022-09-29

Symptoms: Skin cancer basal

Release 12 — day 28, dose 5

2022-10-11

Symptoms: Persistent nausea

Release 12 — day 35, dose 5

2022-10-18

Symptoms: Still have constant nausea.

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	Micrographic skin surgery	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Back pain	·	·	✓
SD	Basal cell carcinoma	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dry eye	✓	·	✓
SD	Nausea	·	·	✓
SD	Sciatica	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Skin cancer	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site swelling	·	·	✓

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