Y2U-10606-64592

5 vaccinations 16 coded responses 36 check-ins 15 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 300 / GA
Registered: 2021-01-30

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-01-27
Dose 1 — Pfizer-BioNTech
2021-01-30
Registered in v-safe
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-02-03
Survey response — day 7, dose 1
MedDRA: Abdominal distension — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: GI BLOATING

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-17
Survey response — day 21, dose 1
MedDRA: Unevaluable event — Feeling: Fair

Free text: Not related to vaccine. I had a new diagnosis today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Dose 2 — Pfizer-BioNTech
2021-02-24
Health check-in — day 0, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Nausea

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — day 7, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — day 14, dose 2
MedDRA: Cough, Pruritus, Rash — Feeling: Good

Free text: Rash, itching, coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 21, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Not related to injection - Im have symptoms from a duplication cyst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 28, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work

Free text: Cardiothoracic surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 35, dose 2
MedDRA: Insomnia, Pain — Feeling: Poor · Be unable to work

Free text: Increases in post surgical pain & insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Cyst — 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, Hospitalization

Free text: Surgery to remive duplication cyst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, 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)
2021-08-25
Survey response — 6 months, dose 2
MedDRA: Urinary tract infection — Feeling: Fair

Free text: UTI

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Dose 3 — Pfizer-BioNTech
2022-02-17
Call 1 — Could Not Reach Participant
2022-04-08
Dose 4 — Pfizer-BioNTech
2022-05-01
Survey response — day 21, dose 4
MedDRA: Intervertebral disc protrusion, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: bulging disc · Healthcare visit (other): surgical site

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-04
Call 1 — Left Voicemail
2022-05-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-08
Survey response — 3 months, dose 4
MedDRA: Laboratory test abnormal, Office visit, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Infection: UTI with additional positive bloodwork · Healthcare visit (other): office visit

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 1 — Left Voicemail
2022-09-25
Dose 5 — Pfizer-BioNTech
2022-09-25
Survey response — day 0, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: no

MedDRA releases: 2024-11 · check-in free text available
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness · None

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-30
Survey response — days 1–6 daily, dose 5
MedDRA: Pre-existing disease — Feeling: Good

Free text: numerous high risk conditions eg hyponatremia asthma

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Health check-in — day 7, dose 5
Feeling: Poor · Joint pains, Muscle or body aches, Nausea, Abdominal pain

Adult check-in
2022-10-09
Survey response — day 14, dose 5
MedDRA: Arthritis — Feeling: Fair

Free text: arthritis

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Survey response — day 21, dose 5
MedDRA: Arthritis, Back pain, Clumsiness, Mobility decreased, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: arthritis, severe back pain,nausea, difficulty moving & clumsiness

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-10-30
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-06
Survey response — day 42, dose 5
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: low back pain worsenef

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Report sent to call center — day 42, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-27
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-03-26
Survey response — 6 months, dose 5
MedDRA: COVID-19, Office visit, Post-acute COVID-19 syndrome — Feeling: Good · 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: 2024-11
2023-03-26
Report sent to call center — 6 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-03-28
Call 1 — Requested Callback
2023-03-29
Call 2 — Left Voicemail
2023-03-31
Call 3 — Left Voicemail
2023-03-31
Callback requested for
12:30PM ET

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Pfizer-BioNTech
2	2021-02-24	Pfizer-BioNTech
3	2021-08-31	Pfizer-BioNTech	No
4	2022-04-08	Pfizer-BioNTech	No
5	2022-09-25	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-28	Successful 2022-11-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-01	Successful 2022-11-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-08	Successful 2022-11-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-06	Successful 2022-11-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-26	Unsuccessful

Free text

Release 3 — day 7, dose 1

2021-02-03

Systemic reaction (other): GI BLOATING

Release 4 — day 21, dose 1

2021-02-17

Symptoms: Not related to vaccine. I had a new diagnosis today.

Release 5 — day 14, dose 2

2021-03-10

Symptoms: Rash, itching, coughing

Release 5 — day 21, dose 2

2021-03-17

Symptoms: Not related to injection - Im have symptoms from a duplication cyst

Release 6 — day 28, dose 2

2021-03-25

Symptoms: Cardiothoracic surgery

Release 6 — day 35, dose 2

2021-03-31

Symptoms: Increases in post surgical pain & insomnia

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Surgery to remive duplication cyst

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: UTI

Release 11 — day 21, dose 4

2022-05-01

Symptoms: bulging disc

Healthcare visit (other): surgical site

Release 12 — 3 months, dose 4

2022-07-08

Symptoms: Infection: UTI with additional positive bloodwork

Healthcare visit (other): office visit

Release 12 — day 0, dose 5

2022-09-25

Systemic reaction (other): no

Release 12 — days 1–6 daily, dose 5

2022-09-30

Systemic reaction (other): numerous high risk conditions eg hyponatremia asthma

Release 12 — day 14, dose 5

2022-10-09

Symptoms: arthritis

Release 12 — day 21, dose 5

2022-10-16

Symptoms: arthritis, severe back pain,nausea, difficulty moving & clumsiness

Release 12 — day 42, dose 5

2022-11-06

Symptoms: low back pain worsenef

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	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthritis	·	·	✓
SD	Back pain	·	·	✓
SD	Clumsiness	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Cyst	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Intervertebral disc protrusion	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	✓	✓	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Urinary tract infection	✓	·	✓
SRO	Abdominal distension	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pre-existing disease	·	·	✓

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