62M-32754-16810

2 vaccinations 10 coded responses 13 check-ins 10 free-text entries 7 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 132 / NY
Registered: 2021-04-14

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
2021-04-13
Dose 2 — Pfizer-BioNTech
2021-04-14
Registered in v-safe
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Syncope — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · 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

Free text: Fainting

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 work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Concussion, Dyspnoea, Loss of consciousness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Still dealing with my concussion from blacking out and continued shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Concussion — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Concussion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 7, dose 2
MedDRA: Concussion, Pulmonary embolism — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, 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: Concussion and pulmonary embolism

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 7, 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)
2021-04-27
Survey response — day 14, dose 2
MedDRA: Condition aggravated, Gastrooesophageal reflux disease, Pre-existing disease, Pulmonary embolism — Feeling: Fair · Be unable to work

Free text: Acid reflux from PE medications

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-11
Survey response — day 28, dose 2
MedDRA: Chest pain, Ear pain, Gastrointestinal disorder, Gastrooesophageal reflux disease, Headache, Visual impairment — Feeling: Fair · Be unable to work, 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: Head pain, visual issues, gastrointestinal issues like reflux, chest pain, ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — day 28, 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)
2021-05-18
Survey response — day 35, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · 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, Outpatient clinic or urgent care clinic visit

Free text: Worsening concussion symptoms from my syncope right after the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 35, 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)
2021-05-25
Survey response — day 42, dose 2
MedDRA: Dizziness — Feeling: Fair · 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, Outpatient clinic or urgent care clinic visit

Free text: A lot of dizzy ness from my concussion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — day 42, 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)
2021-07-13
Survey response — 3 months, dose 2
MedDRA: Chest pain, Concussion, Dyspnoea, Irritable bowel syndrome, Muscle spasms, Pre-existing disease, Syncope — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Major stomach issues like IBS and cramping, in addition to my concussion symptoms from my syncope and continued chest pain/shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
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)
2021-07-15
Call 1 — Left Voicemail
2021-07-16
Call successful
Does not wish to fill out VAERS report
2021-10-12
Survey response — 6 months, dose 2
MedDRA: Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Regular heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-15
Call 1 — Left Voicemail
2022-04-13
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

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

Call center

7 call center cases

6 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Fainting

2021-04-16

Systemic reaction (other): Still dealing with my concussion from blacking out and continued shortness of breath

2021-04-17

Systemic reaction (other): Concussion

Release 7 — day 7, dose 2

2021-04-20

Systemic reaction (other): Concussion and pulmonary embolism

Release 8 — day 14, dose 2

2021-04-27

Symptoms: Acid reflux from PE medications

Release 8 — day 28, dose 2

2021-05-11

Symptoms: Head pain, visual issues, gastrointestinal issues like reflux, chest pain, ear pain

Release 8 — day 35, dose 2

2021-05-18

Symptoms: Worsening concussion symptoms from my syncope right after the vaccine

Release 8 — day 42, dose 2

2021-05-25

Symptoms: A lot of dizzy ness from my concussion

Release 9 — 3 months, dose 2

2021-07-13

Symptoms: Major stomach issues like IBS and cramping, in addition to my concussion symptoms from my syncope and continued chest pain/shortness of breath

Release 10 — 6 months, dose 2

2021-10-12

Symptoms: Regular heart palpitations

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	Chest pain	✓	✓	✓
SD	Concussion	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Irritable bowel syndrome	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pulmonary embolism	✓	✓	✓
SD	Syncope	✓	✓	✓
SD	Visual impairment	✓	✓	✓
SRO	Concussion	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓
SRO	Pulmonary embolism	✓	✓	✓
SRO	Syncope	✓	✓	✓

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