6Q6-14487-00877

4 vaccinations 8 coded responses 22 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Pfizer-BioNTech
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Feeling abnormal — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: I actually felt worse last evening, through the night and this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Pfizer-BioNTech
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 35, dose 2
MedDRA: Medical counselling, Muscle spasms, Pain, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I don't think either is related to vaccine shots, but have had a UTI for over four weeks, just recently got antibiotic. I also have felt real bad the last five days with lower back spasms and a lot of pain. · Healthcare visit (other): Phone call w/primary dr. Couldn't get hold of my pain management dr. Feeling some better today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-17
Survey response — 6 months, dose 2
MedDRA: Coronary arterial stent insertion, Coronary artery occlusion, Hospitalisation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Had an angiogram last week and I had a 95% blocked artery going into the heart. A stent was put in the artery. · Healthcare visit (other): Admitted to hospital where the procedure was done. Released by end of day.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
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)
2021-08-18
Call 1 — Left Voicemail
2021-08-18
Call 1 — Left Voicemail
2021-09-17
Dose 3 — Pfizer-BioNTech
2021-09-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-08
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-29
Survey response — day 42, dose 3
MedDRA: Decubitus ulcer, Pain — Feeling: Good

Free text: In process of trying to heal pressure sores. They're painful, but I'm making progress in their healing. It just takes awhile.

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Dose 4 — Pfizer-BioNTech
2022-09-17
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Genital pain, Kidney infection, Nephrolithiasis, Office visit, Urinary incontinence — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Pain in shoulder and arm. Having shoulder replacement/reverse in October. Pain in female private parts, when I sit down. Having problem with urine control. In Nov & Dec 2021, had kidney stones and kidney infection. · Healthcare visit (other): Appointment visit with surgeon re shoulder surgery.

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 1 — Left Voicemail
2023-04-02
Survey response — 12 months, dose 4
MedDRA: Arthralgia, Shoulder arthroplasty, X-ray abnormal — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Pfizer-BioNTech
2	2021-02-16	Pfizer-BioNTech
3	2021-09-17	Pfizer-BioNTech	No
4	2022-03-31	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): I actually felt worse last evening, through the night and this morning.

2021-01-24

Systemic reaction (other): No

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): No

Release 6 — day 35, dose 2

2021-03-25

Symptoms: I don't think either is related to vaccine shots, but have had a UTI for over four weeks, just recently got antibiotic. I also have felt real bad the last five days with lower back spasms and a lot of pain.

Healthcare visit (other): Phone call w/primary dr. Couldn't get hold of my pain management dr. Feeling some better today.

Release 9 — 6 months, dose 2

2021-08-17

Symptoms: Had an angiogram last week and I had a 95% blocked artery going into the heart. A stent was put in the artery.

Healthcare visit (other): Admitted to hospital where the procedure was done. Released by end of day.

Release 10 — day 42, dose 3

2021-10-29

Symptoms: In process of trying to heal pressure sores. They're painful, but I'm making progress in their healing. It just takes awhile.

Release 12 — 12 months, dose 3

2022-09-17

Symptoms: Pain in shoulder and arm. Having shoulder replacement/reverse in October. Pain in female private parts, when I sit down. Having problem with urine control. In Nov & Dec 2021, had kidney stones and kidney infection.

Healthcare visit (other): Appointment visit with surgeon re shoulder surgery.

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	Hospitalisation	✓	·	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Pain	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Coronary arterial stent insertion	✓	·	✓
SD	Coronary artery occlusion	✓	·	✓
SD	Decubitus ulcer	·	·	✓
SD	Genital pain	·	·	✓
SD	Kidney infection	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Nephrolithiasis	·	·	✓
SD	Pain	✓	✓	✓
SD	Shoulder arthroplasty	·	·	✓
SD	Urinary incontinence	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SD	X-ray abnormal	·	·	✓
SRO	Asthenia	○	✓	○
SRO	Feeling abnormal	✓	·	✓
SRO	No adverse event	✓	✓	✓

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