5Y5-23290-39239

3 vaccinations 7 coded responses 18 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 926 / CA
Registered: 2021-02-02

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

2021-02-02
Registered in v-safe
2021-02-02
Dose 1 — Pfizer-BioNTech
2021-02-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Physiotherapy — Feeling: Good · Fatigue or tiredness

Free text: Overall, I feel physically much stronger than I did before having my first dose. I am working with a Physical Therapist, and I can complete more of the exercises faster than I could 2 days ago and with better extension.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
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
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
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
2021-02-09
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-16
Survey response — day 14, dose 1
MedDRA: Haemoglobin decreased, Intensive care, Transfusion — Feeling: Poor · Be unable to work

Free text: Critically low hemoglobin count. Currently in ICU receiving 2 units of blood.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Dose 2 — Pfizer-BioNTech
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Survey response — day 42, dose 2
MedDRA: Confusional state, Hospitalisation — Feeling: Good · Be unable to work

Free text: Hospitalized for 10 days for confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Survey response — 3 months, dose 2
MedDRA: Dementia — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Diagnosed with Levy body dementia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — 3 months, 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)
2021-08-22
Dose 3 — Pfizer-BioNTech
2021-09-30
Survey response — day 35, dose 3
MedDRA: Cancer pain — Feeling: Fair

Free text: Extreme cancer pain in thigh

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Survey response — day 42, dose 3
MedDRA: Emergency care, Nausea, Pain in extremity — 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 · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Extreme pain in legs, possibly neuropathy related to cancer, but cause not yet confirmed. Nausea, also cause not yet determined. · Healthcare visit (other): (b)(6)triage. In person visit scheduled for next week.

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Report sent to call center — day 42, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-05
Call 1 — Requested Callback
2021-10-06
Callback requested for
04:00PM ET
2021-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-06
Call successful
Completed over the phone
2022-02-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-08-22
Survey response — 12 months, dose 3
MedDRA: Prostate cancer metastatic, Soft tissue sarcoma, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Prostate cancer metastasized to one area of soft tissue. · Healthcare visit (other): Ga68 PSMA-11 scans with (b)(6) follow up scheduled for tomorrow.

MedDRA releases: 2024-11 · check-in free text available
2022-08-22
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-08-23
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Pfizer-BioNTech
2	2021-02-23	Pfizer-BioNTech
3	2021-08-22	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Overall, I feel physically much stronger than I did before having my first dose. I am working with a Physical Therapist, and I can complete more of the exercises faster than I could 2 days ago and with better extension.

Release 4 — day 14, dose 1

2021-02-16

Symptoms: Critically low hemoglobin count. Currently in ICU receiving 2 units of blood.

Release 7 — day 42, dose 2

2021-04-06

Symptoms: Hospitalized for 10 days for confusion

Release 8 — 3 months, dose 2

2021-05-25

Symptoms: Diagnosed with Levy body dementia

Release 9 — day 35, dose 3

2021-09-30

Symptoms: Extreme cancer pain in thigh

Release 9 — day 42, dose 3

2021-10-03

Symptoms: Extreme pain in legs, possibly neuropathy related to cancer, but cause not yet confirmed. Nausea, also cause not yet determined.

Healthcare visit (other): (b)(6)triage. In person visit scheduled for next week.

redacted (b)(6)

Release 12 — 12 months, dose 3

2022-08-22

Symptoms: Prostate cancer metastasized to one area of soft tissue.

Healthcare visit (other): Ga68 PSMA-11 scans with (b)(6) follow up scheduled for tomorrow.

redacted (b)(6)

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	Unevaluable event	·	·	✓
SD	Cancer pain	·	·	✓
SD	Confusional state	✓	✓	✓
SD	Dementia	✓	✓	✓
SD	Haemoglobin decreased	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Intensive care	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Prostate cancer metastatic	·	·	✓
SD	Soft tissue sarcoma	·	·	✓
SD	Transfusion	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Physiotherapy	✓	✓	✓

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