4N6-56562-15044

3 vaccinations 12 coded responses 28 check-ins 12 free-text entries 9 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 189 / PA
Registered: 2021-05-06

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

2021-04-13
Dose 1 — Pfizer-BioNTech
2021-05-04
Dose 2 — Pfizer-BioNTech
2021-05-06
Registered in v-safe
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-11
Survey response — day 7, dose 2
MedDRA: Anxiety, Insomnia — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Anxiety/Insomnia( husband seriously ill)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 14, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have Anxiety disorder.. PTSDdepression multiple back surgeries and pain issues..ok..asthma..insomnia and I manage under physician carehowever a lot of added stress second to critically ill husband in rehab hospital and dealing to that..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-25
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-01
Survey response — day 28, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dealing with anxietyand Spinal issuespart of my medical history..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
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)
2021-06-08
Survey response — day 35, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Stress — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Exacerbation of other health challenges due to severe stress ( anxiety,, IBS, Spine issues)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-03
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-04
Call 1 — Left Voicemail
2021-11-02
Survey response — 6 months, dose 2
MedDRA: Anxiety, Depression, Pain, Stress — Feeling: Fair

Free text: Anxiety issues stress , depression.. pain.. exasperation of.. the mentioneddeath of my husband

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Dose 3 — Pfizer-BioNTech
2021-11-26
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-27
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain — Feeling: Fair

Free text: Mild tender at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-29
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Extreme Anxiety unrelated to vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-30
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Just acute anxiety ( husband's death)

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-30
Call 1 — Left Voicemail
2021-12-01
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-01
Call 1 — Left Voicemail
2021-12-02
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-02
Call 1 — Left Voicemail
2021-12-03
Survey response — day 7, dose 3
MedDRA: Anxiety — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Anxiety ongoing not related to vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-03
Call 1 — Left Voicemail
2021-12-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-07
Survey response — day 42, dose 3
MedDRA: Anxiety disorder, Office visit, Pre-existing disease, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Anxiety, as I have GAD and exasperated by husband's death and now I have an URIhave psychologist I see and resting and hydration for URI

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-10
Call 1 — Left Voicemail
2022-02-25
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-11-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Pfizer-BioNTech
2	2021-05-04	Pfizer-BioNTech
3	2021-11-26	Pfizer-BioNTech	No

Call center

9 call center cases

9 unsuccessful

See the call center timeline

Free text

Release 8 — day 7, dose 2

2021-05-11

Systemic reaction (other): Anxiety/Insomnia( husband seriously ill)

Release 8 — day 14, dose 2

2021-05-18

Symptoms: I have Anxiety disorder.. PTSDdepression multiple back surgeries and pain issues..ok..asthma..insomnia and I manage under physician carehowever a lot of added stress second to critically ill husband in rehab hospital and dealing to that..

Release 8 — day 28, dose 2

2021-06-01

Symptoms: Dealing with anxietyand Spinal issuespart of my medical history..

Release 8 — day 35, dose 2

2021-06-08

Symptoms: Exacerbation of other health challenges due to severe stress ( anxiety,, IBS, Spine issues)

Release 10 — 6 months, dose 2

2021-11-02

Symptoms: Anxiety issues stress , depression.. pain.. exasperation of.. the mentioneddeath of my husband

Release 10 — days 1–6 daily, dose 3

2021-11-27

Systemic reaction (other): Mild tender at injection site

2021-11-29

Systemic reaction (other): Extreme Anxiety unrelated to vaccine

2021-11-30

Systemic reaction (other): Just acute anxiety ( husband's death)

2021-12-01

Systemic reaction (other): Anxiety

2021-12-02

Systemic reaction (other): Anxiety

Release 10 — day 7, dose 3

2021-12-03

Systemic reaction (other): Anxiety ongoing not related to vaccine

Release 10 — day 42, dose 3

2022-01-07

Symptoms: Anxiety, as I have GAD and exasperated by husband's death and now I have an URIhave psychologist I see and resting and hydration for URI

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
SD	Anxiety	·	·	✓
SD	Anxiety disorder	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Depression	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Stress	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Insomnia	✓	✓	✓

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