UN5-53759-24627

4 vaccinations 17 coded responses 50 check-ins 16 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 028 / RI
Registered: 2021-03-05

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

2021-03-04
Dose 1 — Pfizer-BioNTech
2021-03-05
Registered in v-safe
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-11
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Pfizer-BioNTech
2021-03-25
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Survey response — 14 day, dose 2
MedDRA: Pain — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-15
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-24
Survey response — 3 month, dose 2
MedDRA: Arthritis, Myalgia, Pain in extremity, Pre-existing disease — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-09-24
Survey response — 6 month, dose 2
MedDRA: Arthralgia, Gallbladder disorder, Muscle spasms, Office visit, Polyp, Postmenopausal haemorrhage, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-09-24
Report sent to call center — 6 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-27
Call 1 — Left Voicemail
2021-09-29
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-10-03
Survey response — days 1–6 daily, dose 3
MedDRA: Dysgeusia, Stomatitis — Feeling: Fair · Site: Pain · Nausea

MedDRA releases: 2024-11 · check-in answers available
2021-10-04
Survey response — days 1–6 daily, dose 3
MedDRA: Gingival pain, Oral pain, Toothache — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-10-05
Survey response — days 1–6 daily, dose 3
MedDRA: Gingival pain, Oral pain — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-07
Survey response — 7 day, dose 3
MedDRA: Oral discomfort — Feeling: Good · Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-10-13
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-10-20
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-10-27
Survey response — 28 day, dose 3
MedDRA: Cholecystectomy, Gallbladder disorder, Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-10-27
Report sent to call center — 28 day, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-29
Call successful
Does not wish to fill out VAERS report
2021-11-03
Health check-in — 35 day, dose 3
Feeling: Fair

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

Adult check-in
2021-12-29
Health check-in — 3 month, dose 3
Feeling: Fair

Adult check-in
2022-03-30
Health check-in — 6 month, dose 3
Feeling: Fair

Adult check-in
2022-10-01
Survey response — 12 month, dose 3
MedDRA: Nasopharyngitis, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-11-03
Dose 4 — Pfizer-BioNTech
2022-11-03
Survey response — 0 day, dose 4
MedDRA: Dizziness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea

MedDRA releases: 2024-11 · check-in answers available
2022-11-04
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-07
Survey response — days 1–6 daily, dose 4
MedDRA: Disturbance in attention, Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-11-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-10
Survey response — 7 day, dose 4
MedDRA: Balance disorder — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2022-11-17
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2022-11-24
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-12-01
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-12-08
Survey response — 35 day, dose 4
MedDRA: Influenza, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-12-15
Survey response — 42 day, dose 4
MedDRA: Cough, Fatigue, Haemorrhage, Hormone level abnormal, Influenza, Office visit, Postmenopause — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-12-15
Report sent to call center — 42 day, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-02-02
Survey response — 3 month, dose 4
MedDRA: Ovarian cyst, Urinary tract infection — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2023-05-04
Health check-in — 6 month, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Pfizer-BioNTech
2	2021-03-25	Pfizer-BioNTech
3	2021-09-29	Pfizer-BioNTech	Flu
4	2022-11-03	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-24	Successful 2021-10-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-27	Successful 2021-10-29	Does not wish to fill out VAERS report
2022-12-15	Successful 2022-12-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6

Systemic reaction (other): Vertigo

Release 7

Symptoms: Achy

Release 9

Symptoms: Some foot pain and some right hip muscle pain..kick up of arthritic symptoms on knees but that is better now.just party n on right thigh but maybe muscle pull.

Symptoms: post menaposal bleeding, benign polop found, to have d&c. also gallbladder issue, not working right, to have it removed. some arthritic achiness and night leg cramps but had these before.

Healthcare visit (other): regular visits with primary, gastrologist,gyn,surgions

Systemic reaction (other): mouth irritation..metallic taste

Release 10

Systemic reaction (other): mouth soreness,gums teeth

Systemic reaction (other): pallet soreness,gums still but less

Systemic reaction (other): some palate discomfort still

Symptoms: had gallbladder removed yesterday.was not working sufficiently.planned removal.

Healthcare visit (other): outpatient surgery

Release 12

Symptoms: achy, fever, cold symptoms

Systemic reaction (other): dizziness

Systemic reaction (other): woosiness, hard to concentrate

Systemic reaction (other): off balance

Symptoms: had flu with temp few days.getting better now

Symptoms: hormonal,post menaposal issues again.also had flu so still feeling tired and little bronchial cough since then

Healthcare visit (other): gyn visit for bleeding

Free-text releases are not linked to a specific 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	Haemorrhage	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Surgery	·	·	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	✓	✓	✓
SD	Cholecystectomy	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Gallbladder disorder	·	·	✓
SD	Hormone level abnormal	·	·	✓
SD	Influenza	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Ovarian cyst	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Polyp	·	·	✓
SD	Postmenopausal haemorrhage	·	·	✓
SD	Postmenopause	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Balance disorder	·	·	✓
SRO	Disturbance in attention	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dysgeusia	·	·	✓
SRO	Gingival pain	·	·	✓
SRO	Oral discomfort	·	·	✓
SRO	Oral pain	·	·	✓
SRO	Stomatitis	·	·	✓
SRO	Toothache	·	·	✓
SRO	Vertigo	✓	✓	✓

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