5S4-23695-13774

2 vaccinations 7 coded responses 16 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 550 / MN
Registered: 2021-03-28

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

2021-03-23
Dose 1 — Pfizer-BioNTech
2021-03-28
Registered in v-safe
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Back pain, Pain in extremity — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Pain in back, legs, feet and hips.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-30
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Survey response — day 14, dose 1
MedDRA: Chills, Emergency care, Urinary tract infection — Feeling: Fair · 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: Symptoms: I have a UTI and am on antibiotics. So when i had done one of the questionnaires i said i had the chills, but that could of been due to the infection. · Healthcare visit (other): Out patient United Hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-13
Dose 2 — Pfizer-BioNTech
2021-04-13
Survey response — day 0, dose 2
MedDRA: Balance disorder, Fall — Feeling: Poor · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: I lost my balance and fell.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit — Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · 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: In office dental.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-20
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Survey response — day 14, dose 2
MedDRA: Hospitalisation, Nephrostomy — Feeling: Poor · Be unable to work, 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: In hospital for nephrostomy tube replacement. · Healthcare visit (other): 4/26/2021 admission

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper, Back pain, Blood urine present — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nephrostomy tubes not draining. Cramps in stomach along with pain in back. Bloody urine in folly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — day 42, dose 2
MedDRA: Pneumonia, Urinary tract infection — Feeling: Poor · Be unable to do your normal daily activities

Free text: Septic, UTI, possible pneumonia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-28
Call 1 — Could Not Reach Participant
2022-01-03
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Pfizer-BioNTech
2	2021-04-13	Pfizer-BioNTech

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-28

Systemic reaction (other): Pain in back, legs, feet and hips.

Release 7 — day 14, dose 1

2021-04-06

Symptoms: I have a UTI and am on antibiotics. So when i had done one of the questionnaires i said i had the chills, but that could of been due to the infection.

Healthcare visit (other): Out patient United Hospital

Release 7 — day 0, dose 2

2021-04-13

Systemic reaction (other): I lost my balance and fell.

Release 7 — days 1–6 daily, dose 2

2021-04-14

Healthcare visit (other): In office dental.

Release 8 — day 14, dose 2

2021-04-27

Symptoms: In hospital for nephrostomy tube replacement.

Healthcare visit (other): 4/26/2021 admission

Release 8 — day 21, dose 2

2021-05-04

Symptoms: Nephrostomy tubes not draining. Cramps in stomach along with pain in back. Bloody urine in folly.

Release 8 — day 42, dose 2

2021-05-28

Symptoms: Septic, UTI, possible pneumonia

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	Emergency care	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Blood urine present	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Nephrostomy	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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