5R9-17330-89630

3 vaccinations 17 coded responses 33 check-ins 17 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 786 / TX
Registered: 2021-08-16

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Registered dependents

KCE-20966-92517 Adult relative or friend · Female · 2021-08-16

Timeline

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

2021-08-16
Registered in v-safe
2021-08-16
Dose 1 — Pfizer-BioNTech
2021-08-16
Survey response — day 0, dose 1
MedDRA: Paraesthesia — Feeling: Fair

Free text: Left arm has a tingling it

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-08-18
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Constipation

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Confusion

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Constipation

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-22
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Constipation

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-23
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-01
Survey response — day 14, dose 1
MedDRA: Pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shooting pain in bend of foot

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-06
Survey response — day 21, dose 1
MedDRA: Balance disorder, Fatigue, Pain, Pain in extremity, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme fatigue, shooting pain in right foot, equilibrium is off, body soreness worsened

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-08
Dose 2 — Pfizer-BioNTech
2021-09-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-09-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-09-14
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Cough, Oropharyngeal pain — Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Excessive coughing, sore throat pain, chills

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Survey response — day 7, dose 2
MedDRA: Chest discomfort, Chest pain, Haemoptysis, Productive cough, Respiratory tract infection viral, Rhinorrhoea — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Coughing up blood with sputum, pain in chest, tightness in chest, runny nose, respiratory viral infection

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Haemoptysis, Respiratory tract infection — Feeling: Poor · Be unable to do your normal daily activities

Free text: Coughing up blood from aggressive cough, difficulty breathing, respiratory infection

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Survey response — day 21, dose 2
MedDRA: Dyspepsia, Fatigue, Nausea, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Nausea, vomiting, extreme fatigue, heartburn

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-10-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-10-20
Survey response — day 42, dose 2
MedDRA: Cough, Fatigue, Haemoptysis, Office visit, Pulmonary haemorrhage, Viral infection — Feeling: Poor · 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: Viral infection, coughing up blood due to extreme coughing. Busted blood vessels in my lungs according to Doctor. Extreme fatigue exhaustion. Continue to cough

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-25
Call 1 — Left Voicemail
2021-12-08
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Asthma, Balance disorder, Fall, Noninfective sialoadenitis, Pain, Pre-existing disease, Upper respiratory tract infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Shooting pain in hip Upper respiratory infection Asthma went from moderate to severe Salivary gland inflammation on left side of face Equilibrium is off, several unexplained falls

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Dose 3 — Pfizer-BioNTech
2022-02-16
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2022-02-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-18
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-02-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2022-02-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches

Adult check-in
2022-02-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-23
Survey response — day 7, dose 3
MedDRA: Pain, Pain in extremity, Paraesthesia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shooting tingling pain in leg

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Survey response — day 14, dose 3
MedDRA: Epistaxis, Fatigue, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school

Free text: Bloody nose, extreme pain on side of body shot injected, aches, fever, fatigue,

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-03-16
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-03-23
Survey response — day 35, dose 3
MedDRA: Asthma, Fungal infection, Pre-existing disease, Respiratory tract infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Asthma flair ups more consecutive, respiratory infections more frequent Yeast infection

MedDRA releases: 2024-11 · check-in free text available
2022-03-30
Survey response — day 42, dose 3
MedDRA: Abdominal pain upper, Asthma, Nausea, Pre-existing disease, Upper respiratory tract infection, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: URI/exacerbated asthma, stomache nausea and vomiting

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Health check-in — 3 months, dose 3
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-16	Pfizer-BioNTech	No
2	2021-09-08	Pfizer-BioNTech	No
3	2022-02-16	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 9 — day 0, dose 1

2021-08-16

Systemic reaction (other): Left arm has a tingling it

Release 9 — days 1–6 daily, dose 1

2021-08-18

Systemic reaction (other): Constipation

2021-08-19

Systemic reaction (other): Confusion

2021-08-20

Systemic reaction (other): Constipation

2021-08-22

Systemic reaction (other): Constipation

Release 9 — day 14, dose 1

2021-09-01

Symptoms: Shooting pain in bend of foot

Release 9 — day 21, dose 1

2021-09-06

Symptoms: Extreme fatigue, shooting pain in right foot, equilibrium is off, body soreness worsened

Release 9 — days 1–6 daily, dose 2

2021-09-14

Systemic reaction (other): Excessive coughing, sore throat pain, chills

Release 9 — day 7, dose 2

2021-09-16

Systemic reaction (other): Coughing up blood with sputum, pain in chest, tightness in chest, runny nose, respiratory viral infection

Release 9 — day 14, dose 2

2021-09-22

Symptoms: Coughing up blood from aggressive cough, difficulty breathing, respiratory infection

Release 9 — day 21, dose 2

2021-09-29

Symptoms: Nausea, vomiting, extreme fatigue, heartburn

Release 10 — day 42, dose 2

2021-10-20

Symptoms: Viral infection, coughing up blood due to extreme coughing. Busted blood vessels in my lungs according to Doctor. Extreme fatigue exhaustion. Continue to cough

Release 10 — 3 months, dose 2

2021-12-08

Symptoms: Shooting pain in hip Upper respiratory infection Asthma went from moderate to severe Salivary gland inflammation on left side of face Equilibrium is off, several unexplained falls

Release 11 — day 7, dose 3

2022-02-23

Systemic reaction (other): Shooting tingling pain in leg

Release 11 — day 14, dose 3

2022-03-02

Symptoms: Bloody nose, extreme pain on side of body shot injected, aches, fever, fatigue,

Release 11 — day 35, dose 3

2022-03-23

Symptoms: Asthma flair ups more consecutive, respiratory infections more frequent Yeast infection

Release 11 — day 42, dose 3

2022-03-30

Symptoms: URI/exacerbated asthma, stomache nausea and vomiting

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	Abdominal pain upper	·	·	✓
SD	Arthralgia	·	·	✓
SD	Asthma	·	·	✓
SD	Balance disorder	✓	·	✓
SD	Cough	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Epistaxis	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	·	✓
SD	Fungal infection	·	·	✓
SD	Haemoptysis	·	·	✓
SD	Nausea	·	·	✓
SD	Noninfective sialoadenitis	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	✓	·	✓
SD	Pain in extremity	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Pulmonary haemorrhage	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract infection	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Viral infection	·	·	✓
SD	Vomiting	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Chills	·	·	✓
SRO	Confusional state	✓	·	✓
SRO	Constipation	✓	·	✓
SRO	Cough	·	·	✓
SRO	Haemoptysis	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Paraesthesia	✓	·	✓
SRO	Productive cough	·	·	✓
SRO	Respiratory tract infection viral	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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