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5GG-13619-08687

2 vaccinations 15 coded responses 16 check-ins 15 free-text entries 2 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
801 / CO
Registered
2021-04-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-05
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-21
    Registered in v-safe
  3. 2021-04-21
    Dose 2 — Pfizer-BioNTech
  4. 2021-04-21
    Survey response — day 0, dose 2
    MedDRA: Arthralgia, Dizziness, Oropharyngeal pain, Pharyngeal swelling — Feeling: Fair · Site: Pain · Joint pains
    Free text: Right Elbow pain. Slight dizziness. Sore throat. Slight throat swelling.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Lymphadenopathy — Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Cough, swelling at neck lymph nodes,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Neck lymph nodes are still swollen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Good · Muscle or body aches
    Free text: brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pruritus — Feeling: Fair · Headache, Joint pains
    Free text: Scalp and face itching constantly. Body itching sporadically.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Visual impairment, Vitreous floaters — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Sporadic floaters and spots in vision
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Vision blurred — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness
    Free text: Blurred vision later in day
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-28
    Survey response — day 7, dose 2
    MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: A lot of brain fog today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-05
    Survey response — day 14, dose 2
    MedDRA: Arthralgia, Hypoaesthesia, Pain in extremity — Feeling: Fair
    Free text: Numb and achy thumbs and joints at wrists.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-12
    Survey response — day 21, dose 2
    MedDRA: Arthralgia, Chills, Fatigue, Headache, Joint stiffness, Myalgia, Peripheral swelling — Feeling: Poor · Be unable to work
    Free text: Extreme fatigue, chills, joint stiffness and swollen arthritis-like pain in both hands , muscle aches, headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-19
    Survey response — day 28, dose 2
    MedDRA: Dizziness, Fatigue, Urinary tract infection — Feeling: Poor · Be unable to work
    Free text: Extreme fatigue, periods of dizziness, UTI
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-26
    Survey response — day 35, dose 2
    MedDRA: Bone pain, Dizziness, Myalgia — Feeling: Fair
    Free text: Dizziness. Bone and muscle aches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-06-04
    Survey response — day 42, dose 2
    MedDRA: Chest discomfort, Dizziness, Dyspnoea, Sluggishness — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Heavy chest, difficult taking deep breaths, dizziness, sluggish legs
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-07-21
    Survey response — 3 months, dose 2
    MedDRA: Chills, Hypertension, Joint swelling, Office visit, Renal impairment — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Chills, ankle swelling. Low kidney function, high blood pressure, · Healthcare visit (other): Full, ongoing treatment and testing at Covid Clinic at (b)(6)Hospital
    MedDRA releases: 2024-11 · check-in free text available
  18. 2021-07-21
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-07-27
  20. 2021-10-20
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  21. 2022-04-21
    Survey response — 12 months, dose 2
    MedDRA: Amnesia, Blister, Fall, Joint dislocation, Joint swelling, Loss of consciousness, Pain in extremity, Peripheral swelling, Pruritus, Skin discolouration, Skin exfoliation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: *Swelling/achy hands, swelling ankles, dark patches & scaly itching raised blisters on both lower shins. Sjögren's syndrome possibly. *Fell in closet and lost consciousness caused loss of memory and AC Separation. Left shoulder.
    MedDRA releases: 2024-11 · check-in free text available
  22. 2022-04-21
    Report sent to call center — 12 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  23. 2022-04-22
  24. 2022-05-02
  25. 2022-05-05
    Call successful
    Participant prefers to complete VAERS report online
  26. 2022-05-05
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-03-05Pfizer-BioNTech
22021-04-21Pfizer-BioNTech

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 0, dose 2

2021-04-21

Systemic reaction (other): Right Elbow pain. Slight dizziness. Sore throat. Slight throat swelling.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Cough, swelling at neck lymph nodes,

2021-04-23

Systemic reaction (other): Neck lymph nodes are still swollen

2021-04-24

Systemic reaction (other): brain fog

2021-04-25

Systemic reaction (other): Scalp and face itching constantly. Body itching sporadically.

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Sporadic floaters and spots in vision

2021-04-27

Systemic reaction (other): Blurred vision later in day

Release 8 — day 7, dose 2

2021-04-28

Systemic reaction (other): A lot of brain fog today

Release 8 — day 14, dose 2

2021-05-05

Symptoms: Numb and achy thumbs and joints at wrists.

Release 8 — day 21, dose 2

2021-05-12

Symptoms: Extreme fatigue, chills, joint stiffness and swollen arthritis-like pain in both hands , muscle aches, headache

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Extreme fatigue, periods of dizziness, UTI

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Dizziness. Bone and muscle aches

Release 8 — day 42, dose 2

2021-06-04

Symptoms: Heavy chest, difficult taking deep breaths, dizziness, sluggish legs

Release 9 — 3 months, dose 2

2021-07-21

Symptoms: Chills, ankle swelling. Low kidney function, high blood pressure,
Healthcare visit (other): Full, ongoing treatment and testing at Covid Clinic at (b)(6)Hospital
redacted (b)(6)

Release 11 — 12 months, dose 2

2022-04-21

Symptoms: *Swelling/achy hands, swelling ankles, dark patches & scaly itching raised blisters on both lower shins. Sjögren's syndrome possibly. *Fell in closet and lost consciousness caused loss of memory and AC Separation. Left shoulder.

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDAmnesia · · ✓
SDArthralgia ✓ ✓ ✓
SDBlister · · ✓
SDBone pain ✓ ✓ ✓
SDChest discomfort ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDDyspnoea ✓ ✓ ✓
SDFall · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDHypertension · · ✓
SDHypoaesthesia ✓ ✓ ✓
SDJoint dislocation · · ✓
SDJoint stiffness ✓ ✓ ✓
SDJoint swelling · · ✓
SDLoss of consciousness · · ✓
SDMyalgia ✓ ✓ ✓
SDPain in extremity · · ✓
SDPeripheral swelling ✓ ✓ ✓
SDPruritus · · ✓
SDRenal impairment · · ✓
SDSkin discolouration · · ✓
SDSkin exfoliation · · ✓
SDSluggishness ✓ ✓ ✓
SDUrinary tract infection ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROCough ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPharyngeal swelling ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROVision blurred ✓ ✓ ✓
SROVisual impairment ✓ ✓ ✓
SROVitreous floaters ✓ ✓ ✓

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

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