XVA-13135-50172

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 125 / NY
Registered: 2021-07-31

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-07-31
Registered in v-safe
2021-07-31
Dose 1 — Pfizer-BioNTech
2021-07-31
Survey response — 0 day, dose 1
MedDRA: Asthenopia, Fatigue, Immediate post-injection reaction, Product after taste, Vision blurred — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-01
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Headache, Fatigue or tiredness

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-02
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Dysgeusia, Fatigue, Insomnia, Pre-existing disease, Unevaluable event, Upper-airway cough syndrome, Vision blurred — Feeling: Fair · Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-02
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Formication, Pain in extremity, Paraesthesia, Vision blurred — Feeling: Good · Site: Pain · Muscle or body aches

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-07
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-08-14
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-08-21
Dose 2 — Pfizer-BioNTech
2021-08-21
Survey response — 0 day, dose 2
MedDRA: Asthenia — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-22
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Malaise, Pain in extremity — Feeling: Poor · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-23
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary mass — Feeling: Poor · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-23
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-08-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-08-26
Call 1 — Left Voicemail
2021-08-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-08-28
Health check-in — 7 day, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-09-04
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-09-11
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-09-18
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-09-25
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-11-21
Survey response — 3 month, dose 2
MedDRA: Dizziness, Gastrointestinal disorder, Menstruation irregular, Polyp — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-11-21
Report sent to call center — 3 month, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-23
Call 1 — Left Voicemail
2022-02-19
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-31	Pfizer-BioNTech	No
2	2021-08-21	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-02	Unsuccessful
2021-08-23	Unsuccessful
2021-11-21	Unsuccessful

Free text

Release 9

Systemic reaction (other): 15 min. to an hour after first shot I had a taste of medicine in mouth. I also have off and on blurred vision which started about 15 min to an hour after shot. About an hour later, my eyes got heavy like I wanted to sleep. Now, I am tired.

Systemic reaction (other): Tingling in fingers (went away)

Systemic reaction (other): Monday 8/2/2021 - - could not get to sleep last night, -woke up exhausted /blurred vision at 8:30 am -still have metallic taste in mouth, and my stomach is upset. Pulse nasal drip (but I had that before from allergies).

Healthcare visit (other): I sent an email follow up with doctor and I didnt get a response yet.

Systemic reaction (other): August 3 - I felt very good yesterday no problems or symptoms

Systemic reaction (other): 8/4 occurred after report filled-metallic taste, blurred vision 8/5 - creepy crawly feeling in arm and achy, pins and needles in left hand (left arm is where shot was given)

Systemic reaction (other): Feeling of weakness

Systemic reaction (other): Today, I dont feel good and my entire arm hurts up to under my armpit

Systemic reaction (other): Lump in under arm area of left arm where I got the 2nd shot

Release 10

Symptoms: Stomach has been bothering me, but I had a colonoscopy & endoscopy. Everything came back negative including they tested 2 polyps which came back negative. My head has been woozy so I am to get a CAT and MRI. Last menstrual came 2 wks early.

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	Unevaluable event	✓	·	✓
SD	Dizziness	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Polyp	·	·	✓
SRO	Abdominal discomfort	✓	·	✓
SRO	Asthenia	✓	·	✓
SRO	Asthenopia	✓	·	✓
SRO	Axillary mass	✓	·	✓
SRO	Axillary pain	✓	·	✓
SRO	Dysgeusia	✓	·	✓
SRO	Fatigue	✓	·	✓
SRO	Formication	✓	·	✓
SRO	Immediate post-injection reaction	✓	·	✓
SRO	Insomnia	✓	·	✓
SRO	Malaise	✓	·	✓
SRO	No adverse event	✓	·	✓
SRO	Pain in extremity	✓	·	✓
SRO	Paraesthesia	✓	·	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Product after taste	✓	·	✓
SRO	Upper-airway cough syndrome	✓	·	✓
SRO	Vision blurred	✓	·	✓

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