6RP-53945-99876

5 vaccinations 12 coded responses 35 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 500 / IA
Registered: 2021-03-20

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Pfizer-BioNTech
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Free text: My oral digital home temperature is normally under 97.7Â°F

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness

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

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort — Feeling: Good · Abdominal pain

Free text: Spikey sensations in my gut. Not too bad. Didn't last long. Didn't feel ill.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased — Feeling: Good · Headache

Free text: Pulse is high: 74 is the lowest.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Pfizer-BioNTech
2021-04-10
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased — Feeling: Good · Site: Pain, Swelling · Abdominal pain

Free text: Temperature is high average for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Unusually loose stool

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea, Gastrointestinal pain — Feeling: Good

Free text: Slight intestinal cramps and looser than normal stool early today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-24
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Good

Free text: It is unusual for me to have headaches. I've been having headaches since 2nd covid-19 vaccination 04/10/2021.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — day 21, dose 2
MedDRA: Headache, Herpes zoster, Muscle spasms — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Headaches. Shingles (left side) preempted with RX oral antiviral.Muscle spasms - in my back in unusual locations for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Corneal dystrophy, Eye disorder, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I don't know if it is related, & I didn't associate it with vaccination: eye and vision issues beginning @ sometime in 2020. It was diagnosed April 2022 as anterior basement membrane dysphoria (eyes). (It was mis-diagnosed Nov 2021.

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-11
Call 1 — Left Voicemail
2022-04-11
Call successful
Does not wish to fill out VAERS report
2022-05-11
Dose 4 — Pfizer-BioNTech
2022-09-28
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-05
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-02
Survey response — day 35, dose 5
MedDRA: Body temperature increased, Cough, Fatigue, Ocular discomfort, Oropharyngeal pain, Rhinorrhoea, Upper-airway cough syndrome — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Post nasal drainage, sore throat, cough, elevated temporal temperature, nasal drainage, fatigue, pressure around my eyes.

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — day 42, dose 5
MedDRA: Dyspnoea, Fatigue, Pyrexia, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever, congestion, breathing difficulties, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-12-28
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-29
Survey response — 6 months, dose 5
MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Pfizer-BioNTech
2	2021-04-10	Pfizer-BioNTech
3	2021-11-19	Pfizer-BioNTech	Flu
4	2022-05-11	Pfizer-BioNTech	No
5	2022-09-28	Pfizer-BioNTech	Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): My oral digital home temperature is normally under 97.7Â°F

2021-03-25

Systemic reaction (other): Spikey sensations in my gut. Not too bad. Didn't last long. Didn't feel ill.

2021-03-26

Systemic reaction (other): Pulse is high: 74 is the lowest.

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Temperature is high average for me.

2021-04-14

Systemic reaction (other): Unusually loose stool

2021-04-15

Systemic reaction (other): Slight intestinal cramps and looser than normal stool early today.

Release 7 — day 14, dose 2

2021-04-24

Symptoms: It is unusual for me to have headaches. I've been having headaches since 2nd covid-19 vaccination 04/10/2021.

Release 8 — day 21, dose 2

2021-05-01

Symptoms: Headaches. Shingles (left side) preempted with RX oral antiviral.Muscle spasms - in my back in unusual locations for me.

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: I don't know if it is related, & I didn't associate it with vaccination: eye and vision issues beginning @ sometime in 2020. It was diagnosed April 2022 as anterior basement membrane dysphoria (eyes). (It was mis-diagnosed Nov 2021.

Release 12 — day 35, dose 5

2022-11-02

Symptoms: Post nasal drainage, sore throat, cough, elevated temporal temperature, nasal drainage, fatigue, pressure around my eyes.

Release 12 — day 42, dose 5

2022-11-09

Symptoms: Fever, congestion, breathing difficulties, fatigue

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
SD	Body temperature increased	·	·	✓
SD	Corneal dystrophy	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Eye disorder	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SD	Visual impairment	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Gastrointestinal pain	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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