5CG-29044-67361

4 vaccinations 6 coded responses 26 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 077 / NJ
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

2021-03-06
Dose 1 — Pfizer-BioNTech
2021-03-13
Registered in v-safe
2021-03-13
Survey response — day 7, dose 1
MedDRA: Facial pain — Feeling: Poor · Headache, Fatigue or tiredness

Free text: Pain in face like sinus infection - pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 14, dose 1
MedDRA: Chest discomfort, Inflammation, Office visit, Paraesthesia, Paranasal sinus discomfort, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Vaccine on 6th, 7th minor symptoms. 11th servere symptoms. Evening 14th increased pressure in left chest, across back, Inflammation in hands, tingling in back of legs, sinus pressure when head held forward. 15th urgent care. Neg for Coivd. Better now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Dose 2 — Pfizer-BioNTech
2021-03-27
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache

Free text: Not really a headache but light headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-17
Survey response — day 21, dose 2
MedDRA: Ear discomfort, Eye pain, Pain in jaw — Feeling: Good

Free text: Pain in left lower jaw under ear. Pain across left eye. Clogged ears...left more than right.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Pfizer-BioNTech
2021-12-29
Call successful
Participant prefers to complete VAERS report online
2022-03-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Pfizer-BioNTech
2022-04-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-01
Survey response — day 21, dose 4
MedDRA: Pruritus, Urticaria — Feeling: Fair

Free text: Small hives on my face that itch

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-07
Survey response — 6 months, dose 4
MedDRA: Dysuria, Leukocyturia, Ocular discomfort, Pain in jaw — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Severe pain in left jaw. Presure below the left eye and from behind. Leukocytes in urine and burning sensation when urinating. No UTI but symptoms cleared with antibiotics.

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
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)
2022-10-10
Call 1 — Left Voicemail
2023-04-08
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Pfizer-BioNTech
2	2021-03-27	Pfizer-BioNTech
3	2021-10-23	Pfizer-BioNTech	No
4	2022-04-08	Pfizer-BioNTech	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — day 7, dose 1

2021-03-13

Systemic reaction (other): Pain in face like sinus infection - pressure

Release 6 — day 14, dose 1

2021-03-20

Symptoms: Vaccine on 6th, 7th minor symptoms. 11th servere symptoms. Evening 14th increased pressure in left chest, across back, Inflammation in hands, tingling in back of legs, sinus pressure when head held forward. 15th urgent care. Neg for Coivd. Better now cut off by CDC

Release 6 — days 1–6 daily, dose 2

2021-03-30

Systemic reaction (other): Not really a headache but light headedness

Release 7 — day 21, dose 2

2021-04-17

Symptoms: Pain in left lower jaw under ear. Pain across left eye. Clogged ears...left more than right.

Release 11 — day 21, dose 4

2022-05-01

Symptoms: Small hives on my face that itch

Release 12 — 6 months, dose 4

2022-10-07

Symptoms: Severe pain in left jaw. Presure below the left eye and from behind. Leukocytes in urine and burning sensation when urinating. No UTI but symptoms cleared with antibiotics.

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	Chest discomfort	✓	✓	✓
SD	Dysuria	·	·	✓
SD	Ear discomfort	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Leukocyturia	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Office visit	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Pruritus	·	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Facial pain	✓	✓	✓

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