6KM-23961-35265

2 vaccinations 4 coded responses 22 check-ins 4 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 917 / CA
Registered: 2021-03-19

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

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

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

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

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Pfizer-BioNTech
2021-04-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 28, dose 2
MedDRA: Inflammation, Pre-existing disease, Scleritis, Uveitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Uveitis and scleritis. These are new inflammatory conditions related to an previously diagnosed autoimmune disorder. I dont think it is related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Survey response — day 35, dose 2
MedDRA: Pre-existing disease, Uveitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Panuveitis of both eyes. Doctors believe it is a result of a previously diagnosed autoimmune condition.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Survey response — 3 months, dose 2
MedDRA: Office visit, Pre-existing disease, Scleritis, Uveitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Scleritis, uveitis and pain in both eyes. I do not believe this is connected to the vaccination. Additionally I am being screened for my third autoimmune disease. Ill take this over COVIDeven if they are connected. · Healthcare visit (other): Multiple doctor appointments

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-19
Call 1 — Left Voicemail
2021-07-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Autoimmune hepatitis, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Autoimmune hepatitis. Most likely related to my other two autoimmune diagnoses. · Healthcare visit (other): Rheumatologist appt x 2 & labs x 2

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Pfizer-BioNTech
2	2021-04-09	Pfizer-BioNTech

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 8 — day 28, dose 2

2021-05-07

Symptoms: Uveitis and scleritis. These are new inflammatory conditions related to an previously diagnosed autoimmune disorder. I dont think it is related to the vaccine.

Release 8 — day 35, dose 2

2021-05-14

Symptoms: Panuveitis of both eyes. Doctors believe it is a result of a previously diagnosed autoimmune condition.

Release 9 — 3 months, dose 2

2021-07-09

Symptoms: Scleritis, uveitis and pain in both eyes. I do not believe this is connected to the vaccination. Additionally I am being screened for my third autoimmune disease. Ill take this over COVIDeven if they are connected.

Healthcare visit (other): Multiple doctor appointments

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: Autoimmune hepatitis. Most likely related to my other two autoimmune diagnoses.

Healthcare visit (other): Rheumatologist appt x 2 & labs x 2

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	Autoimmune hepatitis	·	·	✓
SD	Inflammation	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Scleritis	✓	✓	✓
SD	Uveitis	✓	✓	✓

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