XZC-13443-29345

2 vaccinations 11 coded responses 13 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 452 / OH
Registered: 2021-06-24

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

2021-06-03
Dose 1 — Pfizer-BioNTech
2021-06-24
Registered in v-safe
2021-06-24
Dose 2 — Pfizer-BioNTech
2021-06-24
Health check-in — 0 day, dose 2
Feeling: Fair · None · Be unable to work or attend school

Adult check-in
2021-06-25
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Oropharyngeal pain — Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-06-27
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-29
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-30
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-01
Survey response — 7 day, dose 2
MedDRA: Fatigue, Infusion, Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-08
Survey response — 14 day, dose 2
MedDRA: Fatigue, Oropharyngeal pain, Peripheral swelling, Swelling face — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-15
Survey response — 21 day, dose 2
MedDRA: Medical counselling, Pain of skin, Peripheral swelling, Rash pruritic, Self-medication, Swelling face, Systemic lupus erythematosus rash — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-07-15
Report sent to call center — 21 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Survey response — 28 day, dose 2
MedDRA: Fatigue, Feeling abnormal, Myalgia, Office visit, Pre-existing disease, Rash pruritic — Feeling: Poor · Be unable to work or attend school

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-07-23
Call 2 — Left Voicemail
2021-08-05
Survey response — 42 day, dose 2
MedDRA: Fatigue, Muscle spasms, Myocardial infarction, Office visit — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-05
Report sent to call center — 42 day, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-25
Survey response — 3 month, dose 2
MedDRA: Rash — 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

MedDRA releases: 2024-11 · check-in answers available
2021-09-25
Report sent to call center — 3 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 · 1 call case(s)
2021-09-29
Call 2 — Left Voicemail
2022-06-24
Survey response — 12 month, dose 2
MedDRA: Pre-existing disease — 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

MedDRA releases: 2024-11 · check-in answers available
2022-06-24
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 · 1 call case(s)
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-03	Pfizer-BioNTech	No
2	2021-06-24	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-15	Successful 2022-06-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-05	Successful 2022-06-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-25	Successful 2022-06-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-24	Successful 2022-06-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 9

Systemic reaction (other): Lack of appetite, sore throat

Systemic reaction (other): Poor appetite

Systemic reaction (other): Runny nose

Systemic reaction (other): Runny Nose,

Systemic reaction (other): I am IgG defcient and get an infusion every 21 days. Today is my 12 hour infusion. It is common to feel run down before an infusion.

Symptoms: Swelling in face and hands. Sore throat. Fatigue

Symptoms: Rash that looked like Lupus appeared on my face. Very itchy. Used Benadryl cream and oral with no relief. Swelling of face and hands with skin sore to touch. 2 days later the rash peeled off with a wash cloth. Assume it was a subcutaneous staph

Healthcare visit (other): Message in MyChart

Symptoms: Itchy rash and muscle pain. Fatigue. I get an IgG infusion every 21 days and feel poorly prior to my infusion. Thursday was my infusion. I do not make immunoglobulin G. Saw my PCP on Wednesday. Unsure if I was recovering from Delta variant of COVID cut off by CDC

Symptoms: Miscle spasms and fatigue. My annual physical revealed I may had a minor myocardial infarction after my 2cd vaccination

Healthcare visit (other): Annual physical and EMG NCV testing ordered prior to vaccinations.

Symptoms: Lupus like rash. PCP thinks I have may have had the Delta variant of COVID

Release 12

Symptoms: Edema I am autoimmune immune deficient. Once Omicron came thorough last November I have had every variant. I get a central line infusion every 3 weeks of IgG and my Beta cells do not form correctly, so no vaccine has worked for about 20 years

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	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	·	✓
SD	Muscle spasms	✓	·	✓
SD	Myalgia	✓	·	✓
SD	Myocardial infarction	✓	·	✓
SD	Office visit	✓	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain of skin	✓	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	✓	·	✓
SD	Self-medication	✓	·	✓
SD	Swelling face	✓	✓	✓
SD	Systemic lupus erythematosus rash	✓	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Infusion	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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