5LM-17636-87991

5 vaccinations 11 coded responses 38 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 392 / MS
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Pfizer-BioNTech
2021-01-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Chills, Dry eye, Dry mouth, Headache, Thirst — Feeling: Fair · Site: Pain · Headache, Joint pains · Be unable to do your normal daily activities

Free text: Dry Eyes and Mouth With Excessive Thirst; Left Side Pain and Headache Better Today than Yesterday; Chills Gone Today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye — Feeling: Good · Joint pains

Free text: Dry Eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Dry Eyes: I had an optical exam today; however, there were no serious eye problems noted. · Healthcare visit (other): I saw my ophthalmologist today; dry eyes noted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-01-27
Survey response — day 14, dose 1
MedDRA: Arthralgia, Dry mouth, Pain in extremity, Thirst — Feeling: Good

Free text: Ive experienced periodic sharp joint pain; especially in my knees and fingers. Excessive thirst and dryness are still noted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 21, dose 1
MedDRA: Alopecia, Dandruff, Dry eye, Dry skin — Feeling: Good

Free text: My hair has been severely shedding and my scalp excessively dry and full of dandruff.I have never, in all my life, had dandruff.My eyes continue to be dry; however, my vision is fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Dose 2 — Pfizer-BioNTech
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Nausea

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Dry skin — Feeling: Good · Nausea

Free text: On-going dry eyes and scalp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Good

Free text: Periodically, I have bad headaches. Yesterday, I had a really bad one, but not today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 35, dose 2
MedDRA: Alopecia, Body temperature decreased, Chills, Headache, Influenza, Self-medication, Sinusitis, Skin exfoliation — Feeling: Good · Be unable to do your normal daily activities

Free text: Last Wk, I had flu/sinusitis symptoms. Took RX of Azithromycin 250 mg & Tylenol on Thursday. I had a sub level temperature, chills & headache.My scalp is not flaking as much but my hair has come out/shedding.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-03-24
Call 1 — Left Voicemail
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Dose 3 — Pfizer-BioNTech
2021-09-30
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-07
Survey response — day 28, dose 3
MedDRA: Sinusitis, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus infection · Healthcare visit (other): Antibiotics RX

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-09
Survey response — 3 months, dose 3
MedDRA: Upper respiratory tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Upper respiratory infection

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-03
Dose 4 — Pfizer-BioNTech
2022-05-14
Survey response — day 7, dose 4
MedDRA: Arthralgia, Chills, Fatigue, Headache, Myalgia, Nausea, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Experienced Chills, Headache, Joint pains, Muscle & Body Aches, Fatigue and Nausea three days after vaccine; had to go to bed. Reported to doctor. Back to normal after 4-5 days.

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-02
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-11-03
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-12-13
Dose 5 — Pfizer-BioNTech
2023-06-13
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Pfizer-BioNTech
2	2021-02-09	Pfizer-BioNTech
3	2021-09-09	Pfizer-BioNTech	No
4	2022-05-03	Pfizer-BioNTech	No
5	2022-12-13	Pfizer-BioNTech	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Dry Eyes and Mouth With Excessive Thirst; Left Side Pain and Headache Better Today than Yesterday; Chills Gone Today

2021-01-16

Systemic reaction (other): Dry Eyes

2021-01-19

Systemic reaction (other): Dry Eyes: I had an optical exam today; however, there were no serious eye problems noted.

Healthcare visit (other): I saw my ophthalmologist today; dry eyes noted.

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Ive experienced periodic sharp joint pain; especially in my knees and fingers. Excessive thirst and dryness are still noted.

Release 3 — day 21, dose 1

2021-02-03

Symptoms: My hair has been severely shedding and my scalp excessively dry and full of dandruff.I have never, in all my life, had dandruff.My eyes continue to be dry; however, my vision is fine.

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): On-going dry eyes and scalp

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Periodically, I have bad headaches. Yesterday, I had a really bad one, but not today.

Release 5 — day 35, dose 2

2021-03-16

Symptoms: Last Wk, I had flu/sinusitis symptoms. Took RX of Azithromycin 250 mg & Tylenol on Thursday. I had a sub level temperature, chills & headache.My scalp is not flaking as much but my hair has come out/shedding.

Release 10 — day 28, dose 3

2021-10-07

Symptoms: Sinus infection

Healthcare visit (other): Antibiotics RX

Release 10 — 3 months, dose 3

2021-12-09

Symptoms: Upper respiratory infection

Release 11 — day 7, dose 4

2022-05-14

Systemic reaction (other): Experienced Chills, Headache, Joint pains, Muscle & Body Aches, Fatigue and Nausea three days after vaccine; had to go to bed. Reported to doctor. Back to normal after 4-5 days.

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	Unevaluable event	·	·	✓
SD	Alopecia	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Body temperature decreased	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Dandruff	✓	✓	✓
SD	Dry eye	✓	✓	✓
SD	Dry mouth	✓	✓	✓
SD	Dry skin	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Skin exfoliation	✓	✓	✓
SD	Thirst	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Dry skin	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Nausea	·	·	✓
SRO	Pain	·	·	✓
SRO	Thirst	✓	✓	✓

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