6X9-23227-51036

5 vaccinations 10 coded responses 51 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 068 / CT
Registered: 2021-01-26

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Pfizer-BioNTech
2021-01-26
Health check-in — day 0, dose 1
Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersomnia — Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I slept EIGHTEEN (18) hours straight from last night at 11pm. Jan 26 11pm - Jan 27 5 pm. My neighbor woke me up after children couldnt reach me. I feel fine though

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Pfizer-BioNTech
2021-02-15
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: I feel a little dizzy....just a little off

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 · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Survey response — day 14, dose 2
MedDRA: Eye pain, Headache, Vision blurred, Visual impairment — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: My eyesight has changed. I have wavy vision and pain behind my left eye. Both eyes have blurred vision that is present even when I put on my glasses. I headaches from the wavy and blurred vision.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-22
Survey response — day 35, dose 2
MedDRA: Hip fracture — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Fracture left hip.Surgery To pin hip 3/15/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 35, 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)
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Dose 3 — Pfizer-BioNTech
2021-10-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2021-12-15
Call 1 — Left Voicemail
2022-01-19
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-17
Dose 4 — Pfizer-BioNTech
2022-02-26
Survey response — day 7, dose 4
MedDRA: Immunosuppression — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Immunosuppresed

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Report sent to call center — day 7, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-03-03
Call 2 — Left Voicemail
2022-03-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-03-17
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-04-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-08-18
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-04
Dose 5 — Pfizer-BioNTech
2022-10-04
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, 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: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-07
Survey response — days 1–6 daily, dose 5
MedDRA: Ear pruritus, Pruritus — Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Whole body Itching esp palms of hands, under chin, ears, back & both arms

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-09
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: NO

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

Adult check-in
2022-10-11
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-18
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-25
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
2022-11-08
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-03
Survey response — 3 months, dose 5
MedDRA: Blood pressure increased, Dysarthria, Mobility decreased, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-01-03
Report sent to call center — 3 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-01-04
Call 1 — Left Voicemail
2023-01-04
Call 1 — Left Voicemail
2023-04-04
Survey response — 6 months, dose 5
MedDRA: Eye operation, Ocular discomfort, Open angle glaucoma — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

MedDRA releases: 2024-11
2023-04-04
Report sent to call center — 6 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2023-04-05
Call 3 — Left Voicemail
2023-04-05
Call 2 — Left Voicemail
2023-04-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Pfizer-BioNTech
2	2021-02-15	Pfizer-BioNTech
3	2021-09-02	Pfizer-BioNTech	No
4	2022-02-17	Pfizer-BioNTech	No
5	2022-10-04	Pfizer-BioNTech	No

Call center

4 call center cases

1 successful · 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

2021-01-27

Systemic reaction (other): I slept EIGHTEEN (18) hours straight from last night at 11pm. Jan 26 11pm - Jan 27 5 pm. My neighbor woke me up after children couldnt reach me. I feel fine though

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): I feel a little dizzy....just a little off

2021-02-20

Systemic reaction (other): Vertigo

Release 4 — day 14, dose 2

2021-03-01

Symptoms: My eyesight has changed. I have wavy vision and pain behind my left eye. Both eyes have blurred vision that is present even when I put on my glasses. I headaches from the wavy and blurred vision.

Release 6 — day 35, dose 2

2021-03-22

Symptoms: Fracture left hip.Surgery To pin hip 3/15/21

Release 11 — day 7, dose 4

2022-02-26

Systemic reaction (other): Immunosuppresed

Release 12 — days 1–6 daily, dose 5

2022-10-07

Systemic reaction (other): Whole body Itching esp palms of hands, under chin, ears, back & both arms

2022-10-09

Systemic reaction (other): NO

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	Eye operation	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Dysarthria	·	·	✓
SD	Eye pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hip fracture	✓	✓	✓
SD	Mobility decreased	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Open angle glaucoma	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Vision blurred	✓	✓	✓
SD	Visual impairment	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pruritus	·	·	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Immunosuppression	·	·	✓
SRO	No adverse event	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Vertigo	✓	✓	✓

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