6AQ-10028-11466

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 070 / NJ
Registered: 2021-07-04

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-07-03
Dose 1 — Pfizer-BioNTech
2021-07-04
Registered in v-safe
2021-07-04
Survey response — days 1–6 daily, dose 1
MedDRA: Swelling of eyelid — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to work or attend school

Free text: Woke up with Left eyelid very swollen. Left arm was injected

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-05
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school

Free text: Rash in both knees continue even using cortisone & fresh aloe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Good · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash continues nit better not worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Survey response — days 1–6 daily, dose 1
MedDRA: Emergency care, Pruritus, Rash — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Rash in knees continues & itchy May go to ER Saturday for it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Survey response — days 1–6 daily, dose 1
MedDRA: Rash, Rash pruritic — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Rash on knees just slightly better Still itchu

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Rash continues on both knees a bit better still some itchiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Survey response — day 7, dose 1
MedDRA: Rash — Feeling: Good · Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Rash on knees better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-24
Dose 2 — Pfizer-BioNTech
2021-07-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-07-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-07-27
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Dysstasia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Very bad lower back pain Hard to sit & get up from sitting position

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Rash on lower back

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-07-30
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Muscle or body aches

Free text: Rash in lower back continues

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-31
Survey response — day 7, dose 2
MedDRA: Rash — Feeling: Good · Joint pains, Muscle or body aches

Free text: Still some rash lower back

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-08-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-09-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-07-24
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-03	Pfizer-BioNTech	No
2	2021-07-24	Pfizer-BioNTech	No

Free text

Release 9 — days 1–6 daily, dose 1

2021-07-04

Systemic reaction (other): Woke up with Left eyelid very swollen. Left arm was injected

2021-07-05

Systemic reaction (other): Rash in both knees continue even using cortisone & fresh aloe

2021-07-06

Systemic reaction (other): Rash continues nit better not worse

2021-07-07

Systemic reaction (other): Rash in knees continues & itchy May go to ER Saturday for it

2021-07-08

Systemic reaction (other): Rash on knees just slightly better Still itchu

2021-07-09

Systemic reaction (other): Rash continues on both knees a bit better still some itchiness

Release 9 — day 7, dose 1

2021-07-10

Systemic reaction (other): Rash on knees better

Release 9 — days 1–6 daily, dose 2

2021-07-27

Systemic reaction (other): Very bad lower back pain Hard to sit & get up from sitting position

2021-07-28

Systemic reaction (other): Rash on lower back

2021-07-30

Systemic reaction (other): Rash in lower back continues

Release 9 — day 7, dose 2

2021-07-31

Systemic reaction (other): Still some rash lower back

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
SRO	Back pain	✓	·	✓
SRO	Dysstasia	✓	·	✓
SRO	Emergency care	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Swelling of eyelid	✓	✓	✓

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