6VA-28661-37608

5 vaccinations 5 coded responses 37 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 145 / NY
Registered: 2021-01-19

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Pfizer-BioNTech
2021-01-19
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Free text: I have crohns disease not sure if that or shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-02
Survey response — day 14, dose 1
MedDRA: Headache, Nausea — Feeling: Fair

Free text: Headaches that settle in my forehead and eyes daily. They make me nauseated at times.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Dose 2 — Pfizer-BioNTech
2021-02-09
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Abdominal discomfort, Crohn's disease, Diarrhoea, Eye irritation, Headache, Oral mucosal eruption, Pre-existing disease, Rash — Feeling: Good · Be unable to do your normal daily activities

Free text: I have crohn's so not sure if vaccine or my immune system on overtime. I developed patchy like rash on cheek an on roof of mouth, eye irritation, upset stomach, diarrhea, and headache. No fever. Symptoms slowly going away. Rash on cheek is the last

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2022-02-09
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-05-19
Dose 4 — Pfizer-BioNTech
2022-10-05
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-05
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Joint pains

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-10
Survey response — days 1–6 daily, dose 5
MedDRA: Respiratory tract congestion — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Free text: Head congestion

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-12
Health check-in — day 7, dose 5
Feeling: Good · Headache, Nausea

Adult check-in
2022-10-21
Survey response — day 14, dose 5
MedDRA: Cough, Dehydration, Ear discomfort, Headache, Influenza virus test negative, Musculoskeletal chest pain, Office visit, Respiratory tract congestion, SARS-CoV-2 test negative, Sinus congestion — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe cough with congestion and sinus congestion. Headache, ears plugged , dehydrated,ribs hurt from coughing so much. Neg for COVID, flu and RSV. · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Report sent to call center — day 14, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-24
Call 1 — Left Voicemail
2022-10-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-16
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-04
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-05
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Pfizer-BioNTech
2	2021-02-09	Pfizer-BioNTech
3	2021-09-29	Pfizer-BioNTech	Flu
4	2022-05-19	Pfizer-BioNTech	No
5	2022-10-05	Pfizer-BioNTech	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): I have crohns disease not sure if that or shot.

Release 3 — day 14, dose 1

2021-02-02

Symptoms: Headaches that settle in my forehead and eyes daily. They make me nauseated at times.

Release 5 — day 28, dose 2

2021-03-09

Symptoms: I have crohn's so not sure if vaccine or my immune system on overtime. I developed patchy like rash on cheek an on roof of mouth, eye irritation, upset stomach, diarrhea, and headache. No fever. Symptoms slowly going away. Rash on cheek is the last cut off by CDC

Release 12 — days 1–6 daily, dose 5

2022-10-10

Systemic reaction (other): Head congestion

Release 12 — day 14, dose 5

2022-10-21

Symptoms: Severe cough with congestion and sinus congestion. Headache, ears plugged , dehydrated,ribs hurt from coughing so much. Neg for COVID, flu and RSV.

Healthcare visit (other): Office visit

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	Abdominal discomfort	✓	✓	✓
SD	Cough	·	·	✓
SD	Crohn's disease	✓	✓	✓
SD	Dehydration	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear discomfort	·	·	✓
SD	Eye irritation	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza virus test negative	·	·	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oral mucosal eruption	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus congestion	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓

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