5JJ-13291-47353

4 vaccinations 14 coded responses 35 check-ins 13 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 606 / IL
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Pfizer-BioNTech
2021-03-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Pfizer-BioNTech
2021-03-26
Survey response — day 0, dose 2
MedDRA: Pruritus — Feeling: Good · Fatigue or tiredness

Free text: Mild Itchy skin all over since March 22.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild itching all over at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Rash, Unevaluable event — Feeling: Good · Muscle or body aches, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Skin doctor appointment to determine cause if itching and rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Pruritus — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Mild itch all over at times · Healthcare visit (other): Office visit to skin doctor to assess inflammatory itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Dry skin, Pre-existing disease — Feeling: Fair · Chills

Free text: Just a little itchy dry skin which seemed to be aggravated by the vaccine or just coincidental.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 35, dose 2
MedDRA: Fatigue, Pollakiuria — Feeling: Good

Free text: Some lingering fatigue ....frequent urination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to work

Free text: I have chronic gastrointestinal problems that have flared up for the last 3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-14
Dose 3 — Pfizer-BioNTech
2022-01-19
Call 1 — Left Voicemail
2022-01-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-19
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-26
Survey response — 12 months, dose 2
MedDRA: Condition aggravated, Gastrooesophageal reflux disease, Pre-existing disease — Feeling: Good · 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Since Covid my acid reflux and GI problems have gotten worse

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Report sent to call center — 12 months, dose 2
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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-03-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-10
Dose 4 — Pfizer-BioNTech
2022-04-15
Survey response — days 1–6 daily, dose 4
MedDRA: Chills, Heart rate increased, Night sweats — Feeling: Fair · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activities

Free text: Night sweats and chills and elevated resting heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-04-16
Survey response — days 1–6 daily, dose 4
MedDRA: Chills — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: No they are mild and manageable. Just the chills are a bother.

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Survey response — day 7, dose 4
MedDRA: Hospitalisation — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I am in the hospital for possible kidney stones today. Not sure if the booster triggered an attack

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — day 7, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-20
Call successful
Does not wish to fill out VAERS report
2022-04-24
Survey response — day 14, dose 4
MedDRA: Chills, Hyperhidrosis, Influenza B virus test positive, Medical counselling, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: I tested positive for influenza B but had no symptoms other than chills and sweats 8 days after my booster. I thought the chills and sweats were from the booster but the hospital said no. I had the flu shot October 2021. · Healthcare visit (other): 4 days to check the flu virus although I did not feel sick.

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-04-25
Call successful
Not applicable - Accidental Reporting
2022-05-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-08
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
2022-05-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-10
Survey response — 12 months, dose 4
MedDRA: Back pain, Gastrointestinal disorder, Hypoaesthesia — Feeling: Good · 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-04-10
Report sent to call center — 12 months, dose 4
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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2023-04-11
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Pfizer-BioNTech
2	2021-03-26	Pfizer-BioNTech
3	2021-11-14	Pfizer-BioNTech	No
4	2022-04-10	Pfizer-BioNTech	No

Call center

6 call center cases

6 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 0, dose 2

2021-03-26

Systemic reaction (other): Mild Itchy skin all over since March 22.

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): No

2021-03-28

Systemic reaction (other): Mild itching all over at times

2021-03-29

Healthcare visit (other): Skin doctor appointment to determine cause if itching and rash

2021-03-30

Systemic reaction (other): Mild itch all over at times

Healthcare visit (other): Office visit to skin doctor to assess inflammatory itching

2021-04-01

Systemic reaction (other): Just a little itchy dry skin which seemed to be aggravated by the vaccine or just coincidental.

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Some lingering fatigue ....frequent urination

Release 8 — day 42, dose 2

2021-05-07

Symptoms: I have chronic gastrointestinal problems that have flared up for the last 3 days.

Release 11 — 12 months, dose 2

2022-03-26

Symptoms: Since Covid my acid reflux and GI problems have gotten worse

Release 11 — days 1–6 daily, dose 4

2022-04-15

Systemic reaction (other): Night sweats and chills and elevated resting heart rate

2022-04-16

Systemic reaction (other): No they are mild and manageable. Just the chills are a bother.

Release 11 — day 7, dose 4

2022-04-17

Systemic reaction (other): I am in the hospital for possible kidney stones today. Not sure if the booster triggered an attack

Release 11 — day 14, dose 4

2022-04-24

Symptoms: I tested positive for influenza B but had no symptoms other than chills and sweats 8 days after my booster. I thought the chills and sweats were from the booster but the hospital said no. I had the flu shot October 2021.

Healthcare visit (other): 4 days to check the flu virus although I did not feel sick.

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	✓	✓	✓
HCVO	Pruritus	✓	✓	✓
HCVO	Rash	✓	✓	✓
HCVO	Unevaluable event	○	✓	✓
SD	Back pain	·	·	✓
SD	Chills	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Influenza B virus test positive	·	·	✓
SD	Medical counselling	·	·	✓
SD	Pollakiuria	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Dry skin	✓	✓	✓
SRO	Heart rate increased	·	·	✓
SRO	Hospitalisation	·	·	✓
SRO	Night sweats	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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