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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

  1. 2021-04-16
    Dose 1 — Pfizer-BioNTech
  2. 2021-05-07
    Dose 2 — Pfizer-BioNTech
  3. 2021-05-13
    Registered in v-safe
  4. 2021-05-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dyspnoea, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free 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 tomkrrow
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-13
    Report sent to call center — days 1–6 daily, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-05-14
    Survey response — day 7, dose 2
    MedDRA: 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, Hospitalization
    Free 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 before
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-14
    Report sent to call center — day 7, 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)
  8. 2021-05-21
    Survey response — day 14, dose 2
    MedDRA: 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, Hospitalization
    Free 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
  9. 2021-05-21
    Report sent to call center — day 14, 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)
  10. 2021-05-28
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  11. 2021-06-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-06-11
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-06-18
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  14. 2021-08-08
    Survey response — 3 months, dose 2
    MedDRA: 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, Hospitalization
    Free 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 defibrillator
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  15. 2021-08-08
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-08-16
  17. 2021-08-17
    Call successful
    Reported to VAERS voluntarily prior to GDIT contact
  18. 2021-11-05
    Survey response — 6 months, dose 2
    MedDRA: 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, Hospitalization
    Free text: Confirmed myocarditis and atrial fibrillation.
    MedDRA releases: 2024-11 · check-in free text available
  19. 2021-11-05
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
  20. 2021-11-08
  21. 2022-05-07
    Survey response — 12 months, dose 2
    MedDRA: 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 visit
    Free 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 procedure
    MedDRA releases: 2024-11 · check-in free text available
  22. 2022-05-07
    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)
  23. 2022-05-09
    Call successful
    Completed over the phone
  24. 2022-05-09
    Call successful
    Completed over the phone

Vaccinations

DoseDateManufacturerCo-administered
12021-04-16Pfizer-BioNTech
22021-05-07Pfizer-BioNTech

Call center

ReportedOutcomeVAERS-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

2021-05-13

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

2021-05-14

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

2021-05-21

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

2021-08-08

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

2021-11-05

Symptoms: Confirmed myocarditis and atrial fibrillation.

Release 11 — 12 months, dose 2

2022-05-07

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
HCVOUterine dilation and curettage · · ✓
SDAtrial fibrillation · · ✓
SDCardiac assistance device user ✓ · ✓
SDCardiac disorder · · ✓
SDCardiac imaging procedure abnormal ✓ · ✓
SDChest discomfort ✓ ✓ ✓
SDDyspnoea ✓ ✓ ✓
SDEmergency care ✓ ✓ ✓
SDEndometrial thickening · · ✓
SDHospitalisation ✓ ✓ ✓
SDImmunisation reaction · · ✓
SDMuscle tightness ✓ ✓ ✓
SDMyocarditis ✓ · ✓
SDOedema ✓ ✓ ✓
SDOffice visit ✓ · ✓
SDParaesthesia ✓ ✓ ✓
SDPostmenopausal haemorrhage · · ✓
SDUterine dilation and curettage · · ✓
SDUterine polyp · · ✓
SROAtrial fibrillation ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SRODyspnoea exertional ✓ ✓ ✓
SROEmergency care ✓ ✓ ✓
SROHospitalisation ✓ ✓ ✓

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