GPV-61299-26090
2 vaccinations
6 coded responses
10 check-ins
6 free-text entries
6 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 481 / MI
- Registered
- 2021-05-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-16
Dose 1 — Pfizer-BioNTech
-
2021-05-07
Dose 2 — Pfizer-BioNTech
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2021-05-13
Registered in v-safe
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2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Shortness of breath, chest tightening, upper back tightening with tingling sensation - this was very prominent after receipt of 2nd Pfizer shot last Friday, has finished considerably but still experience symptoms when walking up a flight of stairs · Healthcare visit (other): Scheduled telehealth appointment for tomkrrowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-13
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-14
Survey response — day 7, dose 2MedDRA: Atrial fibrillation, Dyspnoea exertional, Emergency care, Hospitalisation — Feeling: Poor · Diarrhea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms first experienced the day after 2nd COVID vaccine (Pfizer) returned today and I went to the ER. They admitted me for a fib. I couldnt walk to the bathroom tonight without having difficulty breathing. I didnt have any of this beforeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-14
Report sent to call center — day 7, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-21
Survey response — day 14, dose 2MedDRA: Chest discomfort, Dyspnoea, Emergency care, Hospitalisation, Muscle tightness, Oedema, Paraesthesia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Developed Edema and still had the severe shortness of breath, chest pressure, upper and lower back tightening/tingling. Had to visit ER and hospital stay again 5/18 to 5/19.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-21
Report sent to call center — day 14, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-28
- 2021-06-04
- 2021-06-11
- 2021-06-18
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2021-08-08
Survey response — 3 months, dose 2MedDRA: Cardiac assistance device user, Cardiac imaging procedure abnormal, Myocarditis, Office visit, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, HospitalizationFree text: Symptoms: Results of Cardiac MRI on 7/27 show myocarditis. Dr Salim Hayek, Congenital Heart Specialist at U-M diagnosed this was caused by the Pfizer vaccine. I am now wearing a Life Vest (portable defibrillator) until a PET scan (to test for sarcoidosis). · Healthcare visit (other): Possible EP study is ordered as well for potential permanent defibrillatorMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-08
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-16
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2021-08-17
Call successfulReported to VAERS voluntarily prior to GDIT contact
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2021-11-05
Survey response — 6 months, dose 2MedDRA: Atrial fibrillation, Myocarditis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, HospitalizationFree text: Confirmed myocarditis and atrial fibrillation.MedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2021-11-08
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2022-05-07
Survey response — 12 months, dose 2MedDRA: Cardiac disorder, Endometrial thickening, Immunisation reaction, Postmenopausal haemorrhage, Uterine dilation and curettage, Uterine polyp — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: In addition to now being a lifelong cardiac patient due to the vaccine adverse reaction, I had multiple heavy periods after menopause and had to have a D&C to remove extra thick uterine lining and polyp. · Healthcare visit (other): D&C hospital procedureMedDRA releases: 2024-11 · check-in free text available
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2022-05-07
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-09
Call successfulCompleted over the phone
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2022-05-09
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-16 | Pfizer-BioNTech | |
| 2 | 2021-05-07 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-13 | Successful | Participant prefers to complete VAERS report online |
| 2021-05-14 | Successful | Reported to VAERS voluntarily prior to GDIT contact |
| 2021-05-21 | Successful | Reported to VAERS voluntarily prior to GDIT contact |
| 2021-08-08 | Successful 2021-08-17 |
Reported to VAERS voluntarily prior to GDIT contact |
| 2021-11-05 | Successful 2022-05-09 |
Completed over the phone |
| 2022-05-07 | Successful 2022-05-09 |
Completed over the phone |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Shortness of breath, chest tightening, upper back tightening with tingling sensation - this was very prominent after receipt of 2nd Pfizer shot last Friday, has finished considerably but still experience symptoms when walking up a flight of stairs
Healthcare visit (other): Scheduled telehealth appointment for tomkrrow
Release 8 — day 7, dose 2
Systemic reaction (other): Symptoms first experienced the day after 2nd COVID vaccine (Pfizer) returned today and I went to the ER. They admitted me for a fib. I couldnt walk to the bathroom tonight without having difficulty breathing. I didnt have any of this before
Release 8 — day 14, dose 2
Symptoms: Developed Edema and still had the severe shortness of breath, chest pressure, upper and lower back tightening/tingling. Had to visit ER and hospital stay again 5/18 to 5/19.
Release 9 — 3 months, dose 2
Symptoms: Results of Cardiac MRI on 7/27 show myocarditis. Dr Salim Hayek, Congenital Heart Specialist at U-M diagnosed this was caused by the Pfizer vaccine. I am now wearing a Life Vest (portable defibrillator) until a PET scan (to test for sarcoidosis). cut off by CDC
Healthcare visit (other): Possible EP study is ordered as well for potential permanent defibrillator
Release 10 — 6 months, dose 2
Symptoms: Confirmed myocarditis and atrial fibrillation.
Release 11 — 12 months, dose 2
Symptoms: In addition to now being a lifelong cardiac patient due to the vaccine adverse reaction, I had multiple heavy periods after menopause and had to have a D&C to remove extra thick uterine lining and polyp.
Healthcare visit (other): D&C hospital procedure
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 | Unevaluable event | ✓ | ✓ | ✓ |
| HCVO | Uterine dilation and curettage | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Cardiac assistance device user | ✓ | · | ✓ |
| SD | Cardiac disorder | · | · | ✓ |
| SD | Cardiac imaging procedure abnormal | ✓ | · | ✓ |
| SD | Chest discomfort | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Endometrial thickening | · | · | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Muscle tightness | ✓ | ✓ | ✓ |
| SD | Myocarditis | ✓ | · | ✓ |
| SD | Oedema | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Postmenopausal haemorrhage | · | · | ✓ |
| SD | Uterine dilation and curettage | · | · | ✓ |
| SD | Uterine polyp | · | · | ✓ |
| SRO | Atrial fibrillation | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Dyspnoea exertional | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Hospitalisation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release