XWY-20753-75617

3 vaccinations 3 coded responses 35 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 300 / GA
Registered: 2021-03-21

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

2021-03-20
Dose 1 — Pfizer-BioNTech
2021-03-21
Registered in v-safe
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-04-10
Dose 2 — Pfizer-BioNTech
2021-04-10
Health check-in — 0 day, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — 7 day, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-05-02
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — 28 day, dose 2
MedDRA: Fatigue, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-15
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-05-22
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-07-10
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2021-10-09
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in
2021-11-19
Dose 3 — Pfizer-BioNTech
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · 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
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-26
Health check-in — 7 day, dose 3
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — 14 day, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Health check-in — 21 day, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2021-12-25
Health check-in — 35 day, dose 3
Feeling: Fair

Adult check-in
2022-01-06
Health check-in — 42 day, dose 3
Feeling: Fair

Adult check-in
2022-02-18
Health check-in — 3 month, dose 3
Feeling: Poor

Adult check-in
2022-05-20
Health check-in — 6 month, dose 3
Feeling: Fair

Adult check-in
2022-11-22
Survey response — 12 month, dose 3
MedDRA: Craniocervical dislocation, Muscle spasms, Myelopathy, Neck pain, Office visit, Pain, Physiotherapy, Pre-existing disease, Pyrexia, Torticollis, Unevaluable event — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11 · check-in answers available
2022-11-22
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-11-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Pfizer-BioNTech
2	2021-04-10	Pfizer-BioNTech
3	2021-11-19	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-22	Unsuccessful

Free text

Release 7

Systemic reaction (other): Lightheaded/Dizzy

Release 8

Symptoms: Worse fatigue. Already present before vaccine muscle spasms worse.

Release 12

Symptoms: Diagnosed with Craniocervical Instability. Will need surgery to fuse occiput (back of head) to 3rd vertebra. Painful spasms began 2/16/2020 at which time I ran a low grade temp 99-100.4 every day x 3 months. Diff dx post viral vs Ehlers-Danlos?

Healthcare visit (other): PT x40+, Chrop x 40+, Therapist for chronic medical condition, , Pain Medicine for intractable pain, Neurologist for new Cervical Dystonia, worsening painful neck spasms, Worsenining mylopathy, Occipital , Neurosurgeon specializing EDS etc.

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	Muscle spasms	·	·	✓
HCVO	Myelopathy	·	·	✓
HCVO	Neck pain	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Pain	·	·	✓
HCVO	Physiotherapy	·	·	✓
HCVO	Pre-existing disease	·	·	✓
HCVO	Torticollis	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Craniocervical dislocation	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Dizziness	✓	✓	✓

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