6DJ-21689-80114

3 vaccinations 27 coded responses 30 check-ins 27 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 497 / MI
Registered: 2021-03-16

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Pfizer-BioNTech
2021-03-16
Survey response — day 0, dose 1
MedDRA: Dry mouth, Dysgeusia — Feeling: Good · Site: Itching · Headache, Joint pains

Free text: Metallic taste & cotton mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Pruritus — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brainfog, all over skin itchiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: All over itchiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Haematochezia, Pruritus — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Blood in stool, slight itchiness, slight brainfog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Good · Fatigue or tiredness

Free text: Earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Abnormal dreams, Ear pain, Insomnia, Nasal mucosal blistering, Thirst, Urinary tract discomfort — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Insomnia, vivid dreams, blister inside nose, earache, uncomfortable urination, unquenchable thirst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Conjunctivitis, Thirst — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Unquenchable thirst, woke up with both eyes pink (cloudy too-drinking 28oz water relieved the issue)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 7, dose 1
MedDRA: Conjunctivitis — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: 2 Pink eyes upon waking up-water cleared it up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 14, dose 1
MedDRA: Cyst, Epistaxis, Fatigue, Headache, Skin irritation — Feeling: Fair

Free text: Headaches worsened. Bloody nose off & on. Cyst in nose. Skin irritation above right eye. Fatigued.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-06
Survey response — day 0, dose 2
MedDRA: Dysgeusia, Facial spasm, Muscle spasms — Feeling: Good

Free text: Metallic taste, nerve spasm in jaw, charlie horse in left leg (same side as shot)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Balance disorder, Dry mouth, Dysgeusia, Joint swelling, Lymph node pain, Muscle spasms, Peripheral swelling, Thirst — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Equilibrium off, wierd tastes, muscle cramps/spasms, feet/ankle swelling, sore lower back, sore glands in throat, early dry mouth, extremely thirsty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Apathy, Distractibility, Disturbance in attention, Epistaxis, Feeling abnormal, Joint swelling, Peripheral swelling — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Bloody nose; swollen ankles/feet; lack of motivation; brainfog; easily deterred from tasks; inability to focus (couldn't read, or watch a movie)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Disturbance in attention, Ear pain, Joint swelling, Oropharyngeal pain, Peripheral swelling — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Inability to concentrate: no appetite: swollen feet/ankles; sore throat; earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Disturbance in attention — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Inability to concentrate; no appetite;

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Thirst — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No appetite; unquenchable thirst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Amnesia, Feeling abnormal, Memory impairment, Muscle spasms, Thirst — Feeling: Good · Fever · Muscle or body aches, Fatigue or tiredness

Free text: Brain fog; no memory retention; random muscle cramps/spasms; unquenchable thirst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 7, dose 2
MedDRA: Feeling abnormal, Insomnia, Thirst — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Brainfog; thirst; insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 14, dose 2
MedDRA: Feeling abnormal, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: Leg spasms & cramps in legs/feet/arms/back. Headache/migraine. Sore. Uncoordinated movement (multiple times in a row missing the light switch). Brainfog (things I KNOW but can't say, like familiar names). Using wrong words, or knowing better words.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 21, dose 2
MedDRA: Anxiety, Feeling abnormal, Headache, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Long term Memory issues, coordination issues, droppings things, dyslexia (no dyslexia before), wpm severely dropped, brainfog, vivid dreams, trouble sleeping, emotional · Healthcare visit (other): Went to see family practitioner by regular appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 21, 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)
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — day 35, dose 2
MedDRA: Asthenia, Dyslexia, Fatigue, Headache, Memory impairment, Myalgia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headache, fatigue, muscle soreness, dropping things, memory issues, inability to read, no energy and dyslexia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 42, dose 2
MedDRA: Back pain, Deafness unilateral, Ear discomfort, Neck pain, Pain in extremity, Vision blurred — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of hearing in right ear. Pressure in right ear. Right arm sore (not side from injections) like tennis elbow. Vision occasionally blurry, mainly in right eye. Neck/back soreness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-05
Survey response — 6 months, dose 2
MedDRA: Dizziness, Fall, Memory impairment, Office visit, Speech disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Dizziness, falling, memory issues, & verbal/speech issues. · Healthcare visit (other): In person appt on 10/19/2021

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
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)
2021-10-07
Call 1 — Left Voicemail
2022-04-06
Survey response — 12 months, dose 2
MedDRA: Cough, Headache, Oropharyngeal pain, Respiratory tract congestion, Sinusitis — Feeling: Poor · Be unable to work or attend school

Free text: I currently have a sinus infection. Sore throat, congested, headache, cough, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Dose 3 — Pfizer-BioNTech
2022-10-20
Survey response — days 1–6 daily, dose 3
MedDRA: Aphasia, Brain fog, Depression, Dizziness, Office visit — Feeling: Fair · Site: Itching · Fever · Headache, Joint pains · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Dizzy, extreme brainfog (forgetful of familiar words/wrongwords) and depression · Healthcare visit (other): I had an appointment with Primary care Dr. (b)(6) yesterday

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-21
Survey response — days 1–6 daily, dose 3
MedDRA: Confusional state, Dizziness — Feeling: Good · Headache

Free text: Dizzy/confusion

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Call 1 — Requested Callback
2022-10-21
Call 2 — Requested Callback
2022-10-21
Call 1 — Requested Callback
2022-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-10-24
Survey response — day 7, dose 3
MedDRA: Brain fog, Sleep paralysis — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sleep paralysis. Brain fog.

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Call 2 — Could Not Reach Participant
2022-10-24
Call 3 — Could Not Reach Participant
2022-10-24
Call 2 — Could Not Reach Participant
2022-10-27
Call 3 — Could Not Reach Participant
2022-10-27
Call 3 — Could Not Reach Participant
2022-11-16
Survey response — day 28, dose 3
MedDRA: Aphasia, Brain fog, Headache, Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Issues with my right arm. Ongoing headache. Brainfog and using wrong words- but i know it's the wrong word. · Healthcare visit (other): Regular Office Visits

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-17
Call X — Left Voicemail
2022-11-17
Call X — Left Voicemail
2022-11-17
Call X — Left Voicemail
2022-11-17
Call 1 — Left Voicemail
2022-11-28
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech
3	2022-10-17	Pfizer-BioNTech	No

Call center

4 call center cases

4 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-16

Systemic reaction (other): Metallic taste & cotton mouth

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Brainfog, all over skin itchiness

2021-03-18

Systemic reaction (other): All over itchiness

2021-03-19

Systemic reaction (other): Blood in stool, slight itchiness, slight brainfog

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Earache

2021-03-21

Systemic reaction (other): Insomnia, vivid dreams, blister inside nose, earache, uncomfortable urination, unquenchable thirst

2021-03-22

Systemic reaction (other): Unquenchable thirst, woke up with both eyes pink (cloudy too-drinking 28oz water relieved the issue)

Release 6 — day 7, dose 1

2021-03-23

Systemic reaction (other): 2 Pink eyes upon waking up-water cleared it up

Release 6 — day 14, dose 1

2021-03-30

Symptoms: Headaches worsened. Bloody nose off & on. Cyst in nose. Skin irritation above right eye. Fatigued.

Release 7 — day 0, dose 2

2021-04-06

Systemic reaction (other): Metallic taste, nerve spasm in jaw, charlie horse in left leg (same side as shot)

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Equilibrium off, wierd tastes, muscle cramps/spasms, feet/ankle swelling, sore lower back, sore glands in throat, early dry mouth, extremely thirsty

2021-04-08

Systemic reaction (other): Bloody nose; swollen ankles/feet; lack of motivation; brainfog; easily deterred from tasks; inability to focus (couldn't read, or watch a movie)

2021-04-09

Systemic reaction (other): Inability to concentrate: no appetite: swollen feet/ankles; sore throat; earache

2021-04-10

Systemic reaction (other): Inability to concentrate; no appetite;

2021-04-11

Systemic reaction (other): No appetite; unquenchable thirst

2021-04-12

Systemic reaction (other): Brain fog; no memory retention; random muscle cramps/spasms; unquenchable thirst

Release 7 — day 7, dose 2

2021-04-14

Systemic reaction (other): Brainfog; thirst; insomnia

Release 7 — day 14, dose 2

2021-04-22

Symptoms: Leg spasms & cramps in legs/feet/arms/back. Headache/migraine. Sore. Uncoordinated movement (multiple times in a row missing the light switch). Brainfog (things I KNOW but can't say, like familiar names). Using wrong words, or knowing better words. cut off by CDC

Release 8 — day 21, dose 2

2021-04-29

Symptoms: Long term Memory issues, coordination issues, droppings things, dyslexia (no dyslexia before), wpm severely dropped, brainfog, vivid dreams, trouble sleeping, emotional

Healthcare visit (other): Went to see family practitioner by regular appointment

Release 8 — day 35, dose 2

2021-05-11

Symptoms: Headache, fatigue, muscle soreness, dropping things, memory issues, inability to read, no energy and dyslexia.

Release 8 — day 42, dose 2

2021-05-18

Symptoms: Loss of hearing in right ear. Pressure in right ear. Right arm sore (not side from injections) like tennis elbow. Vision occasionally blurry, mainly in right eye. Neck/back soreness.

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Dizziness, falling, memory issues, & verbal/speech issues.

Healthcare visit (other): In person appt on 10/19/2021

Release 11 — 12 months, dose 2

2022-04-06

Symptoms: I currently have a sinus infection. Sore throat, congested, headache, cough, etc.

Release 12 — days 1–6 daily, dose 3

2022-10-20

Systemic reaction (other): Dizzy, extreme brainfog (forgetful of familiar words/wrongwords) and depression

Healthcare visit (other): I had an appointment with Primary care Dr. (b)(6) yesterday

redacted (b)(6)

2022-10-21

Systemic reaction (other): Dizzy/confusion

Release 12 — day 7, dose 3

2022-10-24

Systemic reaction (other): Sleep paralysis. Brain fog.

Release 12 — day 28, dose 3

2022-11-16

Symptoms: Issues with my right arm. Ongoing headache. Brainfog and using wrong words- but i know it's the wrong word.

Healthcare visit (other): Regular Office Visits

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	Anxiety	✓	✓	✓
SD	Aphasia	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	Cyst	✓	✓	✓
SD	Deafness unilateral	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyslexia	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Epistaxis	✓	✓	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinusitis	·	·	✓
SD	Skin irritation	✓	✓	✓
SD	Speech disorder	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vision blurred	✓	✓	✓
SRO	Abnormal dreams	✓	✓	✓
SRO	Amnesia	✓	✓	✓
SRO	Apathy	✓	✓	✓
SRO	Aphasia	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Confusional state	·	·	✓
SRO	Conjunctivitis	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Depression	·	·	✓
SRO	Distractibility	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Dry mouth	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Facial spasm	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Haematochezia	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nasal mucosal blistering	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sleep paralysis	·	·	✓
SRO	Thirst	✓	✓	✓
SRO	Urinary tract discomfort	✓	✓	✓

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