5YT-17340-17461

4 vaccinations 8 coded responses 29 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 956 / CA
Registered: 2021-01-15

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

2021-01-13
Dose 1 — Pfizer-BioNTech
2021-01-15
Registered in v-safe
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Pfizer-BioNTech
2021-02-03
Survey response — day 0, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Spacy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 21, dose 2
MedDRA: Condition aggravated, Dyspnoea, Nausea, Orthostatic intolerance, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Dysautonomia got worse. Orthostatic intolerance, SOB, nausea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-10
Survey response — day 35, dose 2
MedDRA: Neutropenia, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Neutropenia. Absolute neutrophil count 900Total white blood cell count 2.3 · Healthcare visit (other): Email 4 f/u bloodwork

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Blood urine present, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Blood in urine · Healthcare visit (other): Email re workup

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-11
Call 1 — Left Voicemail
2021-08-11
Call successful
Does not wish to fill out VAERS report
2022-02-01
Dose 3 — Moderna
2022-02-03
Survey response — 12 months, dose 2
MedDRA: Chills, Headache, Malaise, Myalgia — Feeling: Fair

Free text: Post vax chills, myalgias, headache & malaise. Mild. Had full dose Moderna 2d ago. Not sure if text is for this vax vs one B4. ?which pile am I in for this text?

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Dose 4 — Moderna
2022-10-07
Survey response — days 1–6 daily, dose 4
MedDRA: Condition aggravated, Dyspnoea, Orthostatic intolerance, Pre-existing disease — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Orthostatic intolerance & short of breath. Its a vax induced new flare of immune mediated autonomic neuropathy. I was at best function in years before this last covid vax.

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Free text: Feeling better. Just worked out!

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-10-17
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-26
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-14
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-04-03
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Pfizer-BioNTech
2	2021-02-03	Pfizer-BioNTech
3	2022-02-01	Moderna	No
4	2022-10-03	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 3 — day 0, dose 2

2021-02-03

Systemic reaction (other): Spacy

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Dry eyes

Release 4 — day 21, dose 2

2021-02-25

Symptoms: Dysautonomia got worse. Orthostatic intolerance, SOB, nausea.

Release 5 — day 35, dose 2

2021-03-10

Symptoms: Neutropenia. Absolute neutrophil count 900Total white blood cell count 2.3

Healthcare visit (other): Email 4 f/u bloodwork

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Blood in urine

Healthcare visit (other): Email re workup

Release 11 — 12 months, dose 2

2022-02-03

Symptoms: Post vax chills, myalgias, headache & malaise. Mild. Had full dose Moderna 2d ago. Not sure if text is for this vax vs one B4. ?which pile am I in for this text?

Release 12 — days 1–6 daily, dose 4

2022-10-07

Systemic reaction (other): Orthostatic intolerance & short of breath. Its a vax induced new flare of immune mediated autonomic neuropathy. I was at best function in years before this last covid vax.

2022-10-08

Systemic reaction (other): Feeling better. Just worked out!

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	Unevaluable event	✓	✓	✓
SD	Blood urine present	✓	·	✓
SD	Chills	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Neutropenia	✓	✓	✓
SD	Orthostatic intolerance	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Condition aggravated	·	·	✓
SRO	Dry eye	✓	✓	✓
SRO	Dyspnoea	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Orthostatic intolerance	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Unevaluable event	·	·	✓

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