Y22-26069-15342

4 vaccinations 10 coded responses 13 check-ins 10 free-text entries 7 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 064 / CT
Registered: 2021-04-16

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

2021-03-24
Dose 1 — Pfizer-BioNTech
2021-04-14
Dose 2 — Pfizer-BioNTech
2021-04-16
Registered in v-safe
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Fatigue, Malaise, Pain in extremity, Rash, Respiratory tract congestion — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Increased chest congestion, use of inhaler for asthma. Sudden bouts of pain, primarily legs, knees, thighs, shins/calves; also back. Increased overall pain and fatigue, feeling generally unwell, nauseated. Body rash increased.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 14, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-05
Survey response — day 21, dose 2
MedDRA: Asthma, Eczema, Inflammation, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Inflammatory response has increased throughout body. Eczema, asthma flare. · Healthcare visit (other): Primary care visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Survey response — day 28, dose 2
MedDRA: Aphasia, Dysarthria, Hypertension, Palpitations, Thinking abnormal, Unevaluable event — 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

Free text: Symptoms: Heart palpitations, slurred speech, high blood pressure, difficulty sentence forming, slow to process. · Healthcare visit (other): MRI, CT Scan Brain, EKG, blood work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — day 28, dose 2
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)
2021-05-19
Survey response — day 35, dose 2
MedDRA: Aphasia, Dysarthria, Emergency care, Paraesthesia — Feeling: Poor · 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

Free text: Slurred speech, difficulty processing words, sentences. Head, facial, neck tingling to left arm. ER trip w/follow up pending w neuro and cardiology

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — day 35, dose 2
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)
2021-05-28
Survey response — day 42, dose 2
MedDRA: Dyspnoea, Fatigue, Nausea, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Breathing difficulty, congestion, fatigue, nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Fatigue, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat, fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Dose 3 — Pfizer-BioNTech
2021-12-30
Call 2 — Left Voicemail
2022-04-13
Dose 4 — Pfizer-BioNTech
2022-04-14
Survey response — 12 months, dose 2
MedDRA: Blood pressure increased, Dyspnoea, Emergency care, Respiratory tract congestion, Tachycardia — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Shortness of breathe, onset high blood pressure/tachycardia, , increased congestion. Unsure if symptoms are related to vaccinations and booster(s); however, have felt Significantly worse days (3-7) following immunizations/ boosters. Oktocallme. · Healthcare visit (other): ER and follow-up with cardiology and testing.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-19
Call 1 — Left Voicemail
2022-04-25
Survey response — day 7, dose 4
MedDRA: Adverse reaction, Chills, Diarrhoea, Headache, Rash — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Had these symptoms also, as well as headache, diarrhea, chills, rash up through this weekend

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Survey response — day 28, dose 4
MedDRA: Balance disorder, Bone swelling, Dizziness, Fall, Injury, Joint swelling, Nausea, Peripheral swelling — Feeling: Poor · Be unable to do your normal daily activities

Free text: Have continued to be nauseated and dizzy. Fell again on Wednesday (rolled down backyard rock), hurt self badly, left hand swollen, knee, elbow, left ribs, coccyx. Fell 2 weeks ago too, lost balance as well.

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Survey response — 6 months, dose 4
MedDRA: Balance disorder, Fall, Office visit, Pain, Respiratory tract congestion, Rib fracture, X-ray abnormal — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Increased pain, congestion, falls, imbalance. · Healthcare visit (other): Md consult, multiple xrays, fractured ribs 9 & 10 secondary to most-recent fall fall

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call 2 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Pfizer-BioNTech
2	2021-04-14	Pfizer-BioNTech
3	2021-10-25	Pfizer-BioNTech	No
4	2022-04-13	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-28	Unsuccessful
2021-05-05	Unsuccessful
2021-05-12	Unsuccessful
2021-05-19	Unsuccessful
2021-05-28	Unsuccessful
2022-04-14	Unsuccessful
2022-10-14	Unsuccessful

Free text

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Increased chest congestion, use of inhaler for asthma. Sudden bouts of pain, primarily legs, knees, thighs, shins/calves; also back. Increased overall pain and fatigue, feeling generally unwell, nauseated. Body rash increased.

Release 8 — day 21, dose 2

2021-05-05

Symptoms: Inflammatory response has increased throughout body. Eczema, asthma flare.

Healthcare visit (other): Primary care visit

Release 8 — day 28, dose 2

2021-05-12

Symptoms: Heart palpitations, slurred speech, high blood pressure, difficulty sentence forming, slow to process.

Healthcare visit (other): MRI, CT Scan Brain, EKG, blood work.

Release 8 — day 35, dose 2

2021-05-19

Symptoms: Slurred speech, difficulty processing words, sentences. Head, facial, neck tingling to left arm. ER trip w/follow up pending w neuro and cardiology

Release 8 — day 42, dose 2

2021-05-28

Symptoms: Breathing difficulty, congestion, fatigue, nausea

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: Sore throat, fatigue

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: Shortness of breathe, onset high blood pressure/tachycardia, , increased congestion. Unsure if symptoms are related to vaccinations and booster(s); however, have felt Significantly worse days (3-7) following immunizations/ boosters. Oktocallme.

Healthcare visit (other): ER and follow-up with cardiology and testing.

Release 11 — day 7, dose 4

2022-04-25

Systemic reaction (other): Had these symptoms also, as well as headache, diarrhea, chills, rash up through this weekend

Release 11 — day 28, dose 4

2022-05-13

Symptoms: Have continued to be nauseated and dizzy. Fell again on Wednesday (rolled down backyard rock), hurt self badly, left hand swollen, knee, elbow, left ribs, coccyx. Fell 2 weeks ago too, lost balance as well.

Release 12 — 6 months, dose 4

2022-10-14

Symptoms: Increased pain, congestion, falls, imbalance.

Healthcare visit (other): Md consult, multiple xrays, fractured ribs 9 & 10 secondary to most-recent fall fall

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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	Fall	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Rib fracture	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
HCVO	X-ray abnormal	·	·	✓
SD	Aphasia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Balance disorder	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Bone swelling	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysarthria	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Eczema	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Injury	·	·	✓
SD	Joint swelling	·	·	✓
SD	Malaise	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Peripheral swelling	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Tachycardia	·	·	✓
SD	Thinking abnormal	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Chills	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Headache	·	·	✓
SRO	Rash	·	·	✓

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