4PH-31162-31920

4 vaccinations 12 coded responses 46 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 762 / TX
Registered: 2021-03-11

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Pfizer-BioNTech
2021-03-11
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Pfizer-BioNTech
2021-04-08
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Fatigue, Pain, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: Mostly severe allergies I think but ache all over, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-01
Dose 3 — Pfizer-BioNTech
2022-04-01
Survey response — day 0, dose 3
MedDRA: Depression — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Depression related

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Death of relative, Depression, Weight increased — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: My only son died (b)(6), 2022 from cancer. I am depressed. Weight gain trying to eliminate.

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Survey response — days 1–6 daily, dose 3
MedDRA: Depression — Feeling: Fair · Fatigue or tiredness

Free text: Depression

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-07
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Fair

Free text: I have had 3 injections. None recently

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-04-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-04-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-06
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Fatigue, Headache, Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sinus drainage-especially on right nostril, severe headache, sore throat, fatigue, a bout of diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Survey response — day 42, dose 3
MedDRA: Asthenia, Cough, Headache, Malaise, Oropharyngeal pain, Pain, Pulmonary pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Unevaluable event — Feeling: Poor · Be unable to work or attend school, 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: Symptoms: Extremely sick going on second week. Nasal drip, headache, sore throat, lung pain, cough, generalized pain, fever, weakness. Negative home Covid test. Recently receiving medical Rx · Healthcare visit (other): Rx

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Report sent to call center — day 42, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-16
Call 1 — Left Voicemail
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-01
Survey response — 3 months, dose 3
MedDRA: Gastrointestinal stromal tumour, Influenza, Medical counselling, Neoplasm malignant, Office visit, Traumatic lung injury — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: May 4th NonCovid / flu infection Damaged lungs. Malignant Gist tumor between stomach and liver on ligament. Waiting surgery and chemo · Healthcare visit (other): Phone with primary then to office

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Report sent to call center — 3 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

1 call case(s)
2022-07-05
Call 2 — Left Voicemail
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-16
Dose 4 — Pfizer-BioNTech
2022-09-16
Survey response — day 0, dose 4
MedDRA: Cancer surgery, Gastric cancer — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work or attend school

Free text: Recovering from stomach cancer surgery

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-09-20
Survey response — days 1–6 daily, dose 4
MedDRA: Gastric operation, Gastrointestinal stromal tumour — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school

Free text: Recovering from Gist stomach surgery 7/25/2022

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-09-22
Survey response — days 1–6 daily, dose 4
MedDRA: Gastric operation, Gastrointestinal stromal tumour, Glaucoma — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school

Free text: Recovering from stomach surgery stromal Gist tumor removal Glaucoma

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-09-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-14
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-21
Health check-in — day 35, dose 4
Feeling: Poor

Adult check-in
2022-10-28
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-16
Survey response — 3 months, dose 4
MedDRA: Hepatic pain, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain point on liver. Scam scheduled · Healthcare visit (other): Called oncologist and scan date asap

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-19
Call 1 — Left Voicemail
2023-01-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-17
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Pfizer-BioNTech
2	2021-04-01	Pfizer-BioNTech
3	2022-04-01	Pfizer-BioNTech	No
4	2022-09-16	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Mostly severe allergies I think but ache all over, fatigue

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: My only son died (b)(6), 2022 from cancer. I am depressed. Weight gain trying to eliminate.

redacted (b)(6)

Release 11 — day 0, dose 3

2022-04-01

Systemic reaction (other): Depression related

Release 11 — days 1–6 daily, dose 3

2022-04-03

Systemic reaction (other): Depression

2022-04-07

Systemic reaction (other): I have had 3 injections. None recently

Release 11 — day 35, dose 3

2022-05-06

Symptoms: Sinus drainage-especially on right nostril, severe headache, sore throat, fatigue, a bout of diarrhea

Release 11 — day 42, dose 3

2022-05-13

Symptoms: Extremely sick going on second week. Nasal drip, headache, sore throat, lung pain, cough, generalized pain, fever, weakness. Negative home Covid test. Recently receiving medical Rx

Healthcare visit (other): Rx

Release 12 — 3 months, dose 3

2022-07-01

Symptoms: May 4th NonCovid / flu infection Damaged lungs. Malignant Gist tumor between stomach and liver on ligament. Waiting surgery and chemo

Healthcare visit (other): Phone with primary then to office

Release 12 — day 0, dose 4

2022-09-16

Systemic reaction (other): Recovering from stomach cancer surgery

Release 12 — days 1–6 daily, dose 4

2022-09-20

Systemic reaction (other): Recovering from Gist stomach surgery 7/25/2022

2022-09-22

Systemic reaction (other): Recovering from stomach surgery stromal Gist tumor removal Glaucoma

Release 12 — 3 months, dose 4

2022-12-16

Symptoms: Pain point on liver. Scam scheduled

Healthcare visit (other): Called oncologist and scan date asap

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	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Death of relative	·	·	✓
SD	Depression	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal stromal tumour	·	·	✓
SD	Headache	·	·	✓
SD	Hepatic pain	·	·	✓
SD	Influenza	·	·	✓
SD	Malaise	·	·	✓
SD	Neoplasm malignant	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pulmonary pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Traumatic lung injury	·	·	✓
SD	Weight increased	·	·	✓
SRO	Cancer surgery	·	·	✓
SRO	Depression	·	·	✓
SRO	Gastric cancer	·	·	✓
SRO	Gastric operation	·	·	✓
SRO	Gastrointestinal stromal tumour	·	·	✓
SRO	Glaucoma	·	·	✓
SRO	Unevaluable event	·	·	✓

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