HGU-21072-10598

3 vaccinations 4 coded responses 33 check-ins 4 free-text entries 6 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 435 / OH
Registered: 2020-12-17

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

2020-12-15
Dose 1 — Pfizer-BioNTech
2020-12-17
Registered in v-safe
2020-12-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2020-12-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-05
Dose 2 — Pfizer-BioNTech
2021-01-06
Survey response — days 1–6 daily, dose 2
MedDRA: Blindness, Hyperhidrosis, Medical counselling, Paraesthesia, Syncope — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Syncopal episode, complete loss of vision in both eyes (blindness), tingly hands and feet, sweating · Healthcare visit (other): I work at a hospital. I have been checking in with our vaccination team and received direction from our CMO and ED Director.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

2 call case(s)
2021-01-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-02-15
Call 1 — Could Not Reach Participant
2021-02-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-02-16
Call 2 — Left Voicemail
2021-02-16
Call successful
Participant prefers to complete VAERS report online
2021-02-16
Call successful
Participant prefers to complete VAERS report online
2021-02-16
Call successful
Participant prefers to complete VAERS report online
2021-04-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-06
Survey response — 6 months, dose 2
MedDRA: Anxiety, Depression, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: High anxiety and depression · Healthcare visit (other): Weekly psychologist appointments

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-08
Call 1 — Left Voicemail
2021-09-28
Dose 3 — Pfizer-BioNTech
2021-09-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-29
Survey response — 6 months, dose 3
MedDRA: Depression, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Depression · Healthcare visit (other): Primary care physician

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-30
Call 1 — Left Voicemail
2022-09-28
Survey response — 12 months, dose 3
MedDRA: Abortion spontaneous — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Miscarriage

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Report sent to call center — 12 months, dose 3
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-09-29
Call successful
Participant prefers to complete VAERS report online
2022-09-29
Call successful
Participant prefers to complete VAERS report online
2022-09-29
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-15	Pfizer-BioNTech
2	2021-01-05	Pfizer-BioNTech
3	2021-09-28	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-06	Successful 2021-02-16	Participant prefers to complete VAERS report online
2021-01-06	Successful 2021-02-16	Participant prefers to complete VAERS report online
2021-01-07	Successful 2021-02-16	Participant prefers to complete VAERS report online
2021-07-06	Successful 2022-09-29	Participant prefers to complete VAERS report online
2022-03-29	Successful 2022-09-29	Participant prefers to complete VAERS report online
2022-09-28	Successful 2022-09-29	Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 2

2021-01-06

Systemic reaction (other): Syncopal episode, complete loss of vision in both eyes (blindness), tingly hands and feet, sweating

Healthcare visit (other): I work at a hospital. I have been checking in with our vaccination team and received direction from our CMO and ED Director.

Release 9 — 6 months, dose 2

2021-07-06

Symptoms: High anxiety and depression

Healthcare visit (other): Weekly psychologist appointments

Release 11 — 6 months, dose 3

2022-03-29

Symptoms: Depression

Healthcare visit (other): Primary care physician

Release 12 — 12 months, dose 3

2022-09-28

Symptoms: Miscarriage

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abortion spontaneous	·	·	✓
SD	Anxiety	✓	✓	✓
SD	Depression	✓	✓	✓
SRO	Blindness	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Syncope	✓	✓	✓

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