XV6-33165-45510

3 vaccinations 14 coded responses 34 check-ins 14 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 074 / NJ
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Pfizer-BioNTech
2021-03-12
Health check-in — 0 day, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Epistaxis — Feeling: Fair · Site: Pain · Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Pfizer-BioNTech
2021-04-02
Survey response — 0 day, dose 2
MedDRA: Headache, Lymph node pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Head discomfort — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-09
Survey response — 7 day, dose 2
MedDRA: Sinus congestion — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-16
Survey response — 14 day, dose 2
MedDRA: Abdominal pain upper, Arthralgia, Diarrhoea — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-23
Survey response — 21 day, dose 2
MedDRA: Anxiety, Arthropod bite, Contusion, Erythema, Feeling hot, Skin warm, Tenderness, Thrombosis — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-30
Survey response — 28 day, dose 2
MedDRA: Contusion, Pain in extremity, Skin discolouration, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-30
Report sent to call center — 28 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Survey response — 35 day, dose 2
MedDRA: Fatigue, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-07
Report sent to call center — 35 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-07-02
Survey response — 3 month, dose 2
MedDRA: Fatigue, Office visit, Pre-existing disease — 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, Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-02
Report sent to call center — 3 month, 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

1 call case(s)
2021-07-07
Call 1 — Left Voicemail
2021-07-12
Call 2 — Left Voicemail
2021-07-12
Callback requested for
2021-09-28
Dose 3 — Pfizer-BioNTech
2021-10-01
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · 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
2021-10-05
Health check-in — 7 day, dose 3
Feeling: Fair · Chills, 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
2021-10-12
Health check-in — 14 day, dose 3
Feeling: Fair

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

Adult check-in
2021-10-26
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2021-11-03
Health check-in — 35 day, dose 3
Feeling: Fair

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

Adult check-in
2021-12-28
Survey response — 3 month, dose 3
MedDRA: Pyrexia — 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 · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11 · check-in answers available
2021-12-28
Report sent to call center — 3 month, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-12-29
Call 1 — Left Voicemail
2022-03-29
Survey response — 6 month, dose 3
MedDRA: Pre-existing disease — 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 · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11 · check-in answers available
2022-03-29
Report sent to call center — 6 month, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-03-30
Call 1 — Left Voicemail
2022-03-30
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Pfizer-BioNTech
2	2021-04-02	Pfizer-BioNTech
3	2021-09-28	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-30	Successful	Participant prefers to complete VAERS report online
2021-05-07	Successful	Participant prefers to complete VAERS report online
2021-07-02	Successful	Participant prefers to complete VAERS report online
2021-12-28	Successful	Participant prefers to complete VAERS report online
2022-03-29	Successful 2022-03-30	Participant prefers to complete VAERS report online

Free text

Release 5

Systemic reaction (other): Had a bloody nose yesterday

Systemic reaction (other): No

Release 6

Systemic reaction (other): Achy around base of head at back (at lymph nodes?)

Release 7

Systemic reaction (other): Bloody nose

Systemic reaction (other): Full feeling in back of head at base - lymph nodes?

Systemic reaction (other): Tingly feeling in legs last night

Systemic reaction (other): Sinus congestion

Symptoms: Stomach distress (ache and a little diarrhea) and painful knee - though maybe neither are related

Symptoms: Had a red 2-inch diameter circle of tenderness like a warm bruise on inside of my right ankle. Worried that it might be a blood clot, but then decided it was probably an insect bite. Better but still evident after almost 2 days.

Release 8

Symptoms: A blue/purple bruise appeared on my left hand and wrist for no apparent reason. Also continuing pain (from about 2 weeks ago) in my right leg near the knee caused me to worry about blood clots.

Healthcare visit (other): Doppler test

Symptoms: Fatigue

Healthcare visit (other): Office visit with primary care physician

Release 9

Symptoms: Had fatigue attributed to low hemoglobin, which was diagnosed to be caused by MDS.

Healthcare visit (other): These followed a couple of office visits with doctor and blood tests.

Release 10

Symptoms: A fever

Release 11

Symptoms: Fevers from neutropenia from MDS and associated treatments.

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	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthropod bite	·	·	✓
SD	Contusion	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	○
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Skin discolouration	✓	✓	✓
SD	Skin warm	·	·	✓
SD	Tenderness	✓	✓	✓
SD	Thrombosis	✓	✓	○
SRO	Epistaxis	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓

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