4Z9-17816-99131

2 vaccinations 9 coded responses 19 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 322 / FL
Registered: 2021-03-13

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Pfizer-BioNTech
2021-03-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza like illness — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Feels like I have the Flu

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Chest tightness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 7, dose 2
MedDRA: Chest pain, Sneezing, Swelling — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Chest swelling aching when sneeze

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 21, dose 2
MedDRA: Ear discomfort, Secretion discharge — Feeling: Good

Free text: Mucus & ear discomfort (crackling sounds)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 28, dose 2
MedDRA: Ear discomfort, Eye swelling, Lymphadenopathy, Office visit, Swelling, Vision blurred — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pressure in right ear, swollen left eye, swollen sternum, & blurred vision. · Healthcare visit (other): (b)(6) Dr office visit & labs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-13
Survey response — day 35, dose 2
MedDRA: Cough, Eye discharge, Secretion discharge — Feeling: Fair

Free text: My eyes keep running and mucus, awful cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 42, dose 2
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Extreme allergies to MY DOG! Daily mucus from my eyes, and now taking daily meds for this new serious allergy to my dog. · Healthcare visit (other): Dr visit limited contact user as well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-08
Survey response — 3 months, dose 2
MedDRA: Office visit, Pain, Sneezing, Swelling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swelling of sternum and painful sneeze attacks · Healthcare visit (other): Reg Dr visit @ (b)(6) clinic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-12
Call successful
Participant prefers to complete VAERS report online
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-08
Survey response — 12 months, dose 2
MedDRA: Eczema, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Blurred vision, and increased eczema

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-11
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Feels like I have the Flu

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Chest tightness

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): Chest swelling aching when sneeze

Release 8 — day 21, dose 2

2021-04-30

Symptoms: Mucus & ear discomfort (crackling sounds)

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Pressure in right ear, swollen left eye, swollen sternum, & blurred vision.

Healthcare visit (other): (b)(6) Dr office visit & labs

redacted (b)(6)

Release 8 — day 35, dose 2

2021-05-13

Symptoms: My eyes keep running and mucus, awful cough

Release 8 — day 42, dose 2

2021-05-19

Symptoms: Extreme allergies to MY DOG! Daily mucus from my eyes, and now taking daily meds for this new serious allergy to my dog.

Healthcare visit (other): Dr visit limited contact user as well

Release 9 — 3 months, dose 2

2021-07-08

Symptoms: Swelling of sternum and painful sneeze attacks

Healthcare visit (other): Reg Dr visit @ (b)(6) clinic

redacted (b)(6)

Release 11 — 12 months, dose 2

2022-04-08

Symptoms: Blurred vision, and increased eczema

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	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Eczema	·	·	✓
SD	Eye discharge	✓	✓	✓
SD	Eye swelling	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Secretion discharge	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Swelling	✓	✓	✓

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