XWH-29767-16114

2 vaccinations 7 coded responses 15 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 956 / CA
Registered: 2021-03-02

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-08
Dose 1 — Pfizer-BioNTech
2021-03-01
Dose 2 — Pfizer-BioNTech
2021-03-02
Registered in v-safe
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — 7 day, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — 14 day, dose 2
MedDRA: Insomnia, Medical counselling, Oral discomfort, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-17
Report sent to call center — 14 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-03-29
Survey response — 28 day, dose 2
MedDRA: Blood glucose increased, Hypertension, Muscular weakness, Oral discomfort, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-05
Survey response — 35 day, dose 2
MedDRA: Myalgia — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-12
Survey response — 42 day, dose 2
MedDRA: Abdominal discomfort, Somnolence — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-31
Survey response — 3 month, dose 2
MedDRA: Balance disorder, Office visit, Peripheral swelling — Feeling: Fair · 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
2021-05-31
Report sent to call center — 3 month, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-30
Survey response — 6 month, dose 2
MedDRA: Muscle disorder — Feeling: Fair · Be unable to do your normal daily activities, 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: 2021-09,2024-11 · check-in answers available
2021-08-30
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)
2021-08-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-01
Survey response — 12 month, dose 2
MedDRA: Blood sodium decreased, Emergency care, Hospitalisation, Office visit, Renal injury — Feeling: Fair · 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: 2024-11 · check-in answers available
2022-03-01
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

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-03-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Pfizer-BioNTech
2	2021-03-01	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-17	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-31	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-30	Successful 2021-08-31	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-01	Unsuccessful

Free text

Release 5

Symptoms: My lips be burning. Some times I couldnt sleep open my mouth Arm. Still hurts

Healthcare visit (other): Hospic nurse came over

Release 6

Symptoms: My legs are weak and my lips are burning, blood pressure and blood sugar is out of control. I have a neuromuscular condition

Symptoms: Muscles hurt

Release 7

Symptoms: Upset stomach and drowsy

Release 8

Symptoms: Losing balance. Swelling in feet.

Healthcare visit (other): Doctors clinic.

Release 9

Symptoms: Muscles problems

Release 11

Symptoms: Very low sodium-damaged kidney. Had to be hospitalized.

Healthcare visit (other): Primary care physician told me to go to emergency room

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	Emergency care	·	·	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Blood glucose increased	✓	✓	✓
SD	Blood sodium decreased	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Hypertension	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Muscle disorder	✓	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Oral discomfort	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Renal injury	·	·	✓
SD	Somnolence	✓	✓	✓

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