XW5-30491-91348

2 vaccinations 10 coded responses 17 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-01-24

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

2021-01-20
Dose 1 — Pfizer-BioNTech
2021-01-24
Registered in v-safe
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Erythema, Headache, Nausea, Pruritus, Pyrexia, Tremor — Feeling: Good · Site: Pain · Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Fever · Headache, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-01-27
Health check-in — 7 day, dose 1
Feeling: Good · Site: Pain · Headache, Nausea

Adult check-in
2021-02-03
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-02-12
Survey response — 21 day, dose 1
MedDRA: Vertigo, Vomiting — 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-12
Report sent to call center — 21 day, dose 1
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)
2021-02-17
Survey response — 28 day, dose 1
MedDRA: Dizziness, Emergency care, Medical counselling, Nausea, Vertigo, Vomiting — 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-17
Report sent to call center — 28 day, dose 1
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)
2021-02-19
Dose 2 — Pfizer-BioNTech
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Chills, Headache, Pyrexia, Rash — Feeling: Fair · Site: Pain, Redness · Headache, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — 7 day, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-05
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — 28 day, dose 2
MedDRA: Rash — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-26
Survey response — 35 day, dose 2
MedDRA: Rash, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-26
Report sent to call center — 35 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Survey response — 42 day, dose 2
MedDRA: Rash, Urticaria — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-02
Report sent to call center — 42 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-11
Call 1 — Could Not Reach Participant
2021-06-16
Call 2 — Left Voicemail
2021-08-20
Survey response — 6 month, dose 2
MedDRA: Dyspnoea, Heart rate increased, Hyperthyroidism, Palpitations, Wound cellulitis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2024-11 · check-in answers available
2022-02-22
Survey response — 12 month, dose 2
MedDRA: Arthralgia, Office visit, Pain in extremity — 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
2022-02-22
Report sent to call center — 12 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Pfizer-BioNTech
2	2021-02-19	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-02-12	Unsuccessful
2021-02-17	Unsuccessful
2021-03-26	Unsuccessful
2021-04-02	Unsuccessful
2022-02-22	Unsuccessful

Free text

Release 2

Systemic reaction (other): Very itchy palms, soles on feet, breasts

Systemic reaction (other): By the time I was able to enroll in this site, most of the initial symptoms got better. Initial injection 1/20/21 11:PM. However body shaking chills, severe headache, nausea and 102.5 fever started at 3:00 PM feet, hands breasts all got red and itchy. All lasted about 3 days.

Release 4

Symptoms: Vertigo and vomiting

Symptoms: Had to go to ER on 2/10/21 extreme dizziness, nausea and vomiting. Dx: vertigo. Never had it before.

Healthcare visit (other): Follow up visit today with my PCP.

Systemic reaction (other): 12 hrs after receiving 2nd shot i developed a total body rash, fever, chills, headache, i still have a rash in different areas

Release 6

Symptoms: The full body rash returned

Symptoms: On 3/19/21 i came down again with full body hives and rash. The first time this happened was 12 hours following the 2nd Phizer vaccine on 2/19/21.

Symptoms: Full body rash and welts on 3/19/21. I continue getting rashes and take Hydroxyzine to aleviate symptomsThis first happened on 2/19/21 12 hours after 2nd Phizer vaccine.

Release 9

Symptoms: Short of breath at times. Developed palputations, rapid heartbeat Dx: hyperthyroidism. Keep getting cellulitis when cut or scratched.

Release 11

Symptoms: Shoulder and arm pain. Possible cause from rotator cuff tear or cervical disc. Now waiting for authorization. From UHC!!!!

Healthcare visit (other): Orthopedic surgeon office

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
SD	Arthralgia	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SD	Emergency care	✓	✓	✓
SD	Heart rate increased	✓	·	✓
SD	Hyperthyroidism	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Palpitations	✓	·	✓
SD	Rash	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vertigo	✓	✓	✓
SD	Vomiting	✓	✓	✓
SD	Wound cellulitis	✓	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Tremor	✓	✓	✓

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