69H-13891-56070

4 vaccinations 8 coded responses 36 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 852 / AZ
Registered: 2021-03-19

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

2021-02-26
Dose 1 — Pfizer-BioNTech
2021-03-19
Registered in v-safe
2021-03-19
Dose 2 — Pfizer-BioNTech
2021-03-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: After yesterdays report i had extremw fatigue. Ok tiday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — day 14, dose 2
MedDRA: Blood calcium increased, Blood pressure increased, Diarrhoea, Hypertension, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diarrhea 3 times, sudden onset of high blood pressure with readings as high as 202/113. Blood panel showed high calcium and borderline glucose. Following up w dr james lieber. · Healthcare visit (other): Visit in office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Survey response — day 28, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-18
Survey response — 3 months, dose 2
MedDRA: Pelvic fracture — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Fractured pelvis. Dosage if Ol m esartan hcl increased from 20/12.5 to 40/12.5

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Call 1 — Left Voicemail
2021-09-17
Survey response — 6 months, dose 2
MedDRA: Change of bowel habit, Diarrhoea — Feeling: Poor · 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: Bowel habit changes and watery diarrhea

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-20
Call 1 — Left Voicemail
2021-09-29
Dose 3 — Pfizer-BioNTech
2021-10-01
Survey response — days 1–6 daily, dose 3
MedDRA: Office visit — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Diarrhea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Gastroenteroligist

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Diarrhea

Adult check-in
2021-10-03
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Diarrhea

Free text: Diarrhea predates booster

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Diarrhea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-10-04
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Diarrhea

Adult check-in
2021-10-06
Health check-in — day 7, dose 3
Feeling: Good · Diarrhea

Adult check-in
2021-10-07
Call 1 — Left Voicemail
2021-10-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-01
Dose 4 — Pfizer-BioNTech
2022-04-14
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-03
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-30
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-01
Survey response — 12 months, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Pfizer-BioNTech
2	2021-03-19	Pfizer-BioNTech
3	2021-09-29	Pfizer-BioNTech	No
4	2022-04-01	Pfizer-BioNTech	No

Call center

5 call center cases

1 successful · 4 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-24

Systemic reaction (other): After yesterdays report i had extremw fatigue. Ok tiday.

Release 6 — day 14, dose 2

2021-04-02

Symptoms: Diarrhea 3 times, sudden onset of high blood pressure with readings as high as 202/113. Blood panel showed high calcium and borderline glucose. Following up w dr james lieber.

Healthcare visit (other): Visit in office

Release 7 — day 28, dose 2

2021-04-16

Symptoms: Diarrhea

Release 9 — 3 months, dose 2

2021-06-18

Symptoms: Fractured pelvis. Dosage if Ol m esartan hcl increased from 20/12.5 to 40/12.5

Release 9 — 6 months, dose 2

2021-09-17

Symptoms: Bowel habit changes and watery diarrhea

Release 9 — days 1–6 daily, dose 3

2021-10-01

Healthcare visit (other): Gastroenteroligist

2021-10-03

Systemic reaction (other): Diarrhea predates booster

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	Office visit	✓	✓	✓
SD	Blood calcium increased	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Change of bowel habit	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Pelvic fracture	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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