5N3-19017-72015

4 vaccinations 14 coded responses 26 check-ins 14 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 493 / MI
Registered: 2021-03-01

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-26
Dose 1 — Pfizer-BioNTech
2021-03-01
Registered in v-safe
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: MS, ankylosing spondylitis, chronic headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-26
Dose 2 — Pfizer-BioNTech
2021-03-26
Survey response — day 0, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I have MS and rheumatic type arthritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: MS, Ankylosing spodylitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — day 7, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-04-18
Survey response — day 21, dose 2
MedDRA: Tendonitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Tendinitis in foot and toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — day 28, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in feet and hips is worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 42, dose 2
MedDRA: Dyspnoea, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I am having breathing problems that are worsening. · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-26
Survey response — 3 months, dose 2
MedDRA: Abdominal discomfort, Back pain, Bladder discomfort, Medical counselling, Vision blurred — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Loss of bowel and bladder function, vision all blurry, severe pain in lower back so much that I needed help to do anything. · Healthcare visit (other): Daughter talked to my PCP

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Report sent to call center — 3 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

1 call case(s)
2021-06-30
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-23
Dose 3 — Pfizer-BioNTech
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-04
Survey response — day 42, dose 3
MedDRA: Drug hypersensitivity, Hospitalisation, Pyrexia, Rash — Feeling: Good · Be unable to do your normal daily activities

Free text: Allergic reaction to a sulfa drug. Rash and fever. Hospitalized for 6 days.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — 3 months, dose 3
MedDRA: Drug hypersensitivity — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Allergic reaction to sulpha drug

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-21
Survey response — 6 months, dose 3
MedDRA: Fall, Fatigue, Lower respiratory tract infection, Musculoskeletal pain, Office visit, Pre-existing disease, Productive cough — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: A bad chest cold for 2+ weeks. Not covid not influenza A or B. Just a dumb cold with productive cough and fatigue. Itherwise, I've been good. I also fell and have a really painful butt(thanks to my MS). Nothing to do with my immunization. · Healthcare visit (other): Regular PCP appointment

MedDRA releases: 2024-11 · check-in free text available
2022-02-21
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-23
Call successful
Does not wish to fill out VAERS report
2022-04-27
Dose 4 — Pfizer-BioNTech
2022-05-14
Survey response — day 14, dose 4
MedDRA: Ankylosing spondylitis, Arthralgia, Back pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe pain lower back, right hip down side of leg. Also severe pain in left heel, only when standing or walking. Probably due to ankylosing spondylitis.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — day 21, dose 4
MedDRA: Back injury, Fall, Joint injury, Limb injury, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I fell and hurt my hips , lower back and shoulder. · Healthcare visit (other): PCP visit

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-19
Call 1 — Left Voicemail
2022-05-19
Call 1 — Left Voicemail
2022-05-19
Call 1 — Left Voicemail
2022-05-19
Call 1 — Left Voicemail
2022-05-19
Call 1 — Left Voicemail
2022-05-30
Survey response — day 28, dose 4
MedDRA: Pyrexia, Rash, Rash erythematous, Rash papular, Rash vesicular — Feeling: Poor · Be unable to work or attend school, 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: Fever and rash all over. Some just red and slightly raised, some blistered

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Report sent to call center — day 28, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-01
Call successful
Participant prefers to complete VAERS report online
2022-06-14
Survey response — day 42, dose 4
MedDRA: Herpes zoster, Office visit — Feeling: Fair · 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: Symptoms: I have shingles · Healthcare visit (other): Primary care doctor

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Report sent to call center — day 42, 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)
2022-06-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Pfizer-BioNTech
2	2021-03-26	Pfizer-BioNTech
3	2021-08-23	Pfizer-BioNTech	No
4	2022-04-27	Pfizer-BioNTech	No

Call center

7 call center cases

7 successful

3 waits over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): MS, ankylosing spondylitis, chronic headaches

Release 6 — day 0, dose 2

2021-03-26

Systemic reaction (other): I have MS and rheumatic type arthritis

Release 6 — days 1–6 daily, dose 2

2021-03-30

Systemic reaction (other): MS, Ankylosing spodylitis

Release 7 — day 21, dose 2

2021-04-18

Symptoms: Tendinitis in foot and toes

Release 8 — day 28, dose 2

2021-04-27

Symptoms: Pain in feet and hips is worse.

Release 8 — day 42, dose 2

2021-05-07

Symptoms: I am having breathing problems that are worsening.

Healthcare visit (other): Doctors office

Release 9 — 3 months, dose 2

2021-06-26

Symptoms: Loss of bowel and bladder function, vision all blurry, severe pain in lower back so much that I needed help to do anything.

Healthcare visit (other): Daughter talked to my PCP

Release 10 — day 42, dose 3

2021-10-04

Symptoms: Allergic reaction to a sulfa drug. Rash and fever. Hospitalized for 6 days.

Release 10 — 3 months, dose 3

2021-11-22

Symptoms: Allergic reaction to sulpha drug

Release 11 — 6 months, dose 3

2022-02-21

Symptoms: A bad chest cold for 2+ weeks. Not covid not influenza A or B. Just a dumb cold with productive cough and fatigue. Itherwise, I've been good. I also fell and have a really painful butt(thanks to my MS). Nothing to do with my immunization.

Healthcare visit (other): Regular PCP appointment

Release 11 — day 14, dose 4

2022-05-14

Symptoms: Severe pain lower back, right hip down side of leg. Also severe pain in left heel, only when standing or walking. Probably due to ankylosing spondylitis.

Release 11 — day 21, dose 4

2022-05-18

Symptoms: I fell and hurt my hips , lower back and shoulder.

Healthcare visit (other): PCP visit

Release 11 — day 28, dose 4

2022-05-30

Symptoms: Fever and rash all over. Some just red and slightly raised, some blistered

Release 12 — day 42, dose 4

2022-06-14

Symptoms: I have shingles

Healthcare visit (other): Primary care doctor

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Ankylosing spondylitis	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back injury	·	·	✓
SD	Back pain	✓	✓	✓
SD	Bladder discomfort	✓	✓	✓
SD	Condition aggravated	○	○	○
SD	Drug hypersensitivity	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fall	·	·	✓
SD	Fatigue	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Joint injury	·	·	✓
SD	Limb injury	·	·	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Musculoskeletal pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	○	○	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Rash erythematous	·	·	✓
SD	Rash papular	·	·	✓
SD	Rash vesicular	·	·	✓
SD	Tendonitis	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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