Y3Q-22404-21454

2 vaccinations 8 coded responses 16 check-ins 8 free-text entries 6 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 441 / OH
Registered: 2021-03-14

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

2021-03-13
Dose 1 — Pfizer-BioNTech
2021-03-14
Registered in v-safe
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Immediate post-injection reaction, Syncope — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Dizziness, fainted after the shot when administered yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-20
Survey response — day 7, dose 1
MedDRA: Dizziness, Ear discomfort, Tinnitus — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Persistent dizziness and ringing in ears (especially left ear). Feeling of fullness. Has been going on for a week but I didnt type it out when the other symptoms were more noticeable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Survey response — day 14, dose 1
MedDRA: Post concussion syndrome, Syncope — Feeling: Poor · Be unable to work, 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

Free text: Experiencing post concussive syndrome after fainting following receipt of the first dose of the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 14, dose 1
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)
2021-04-08
Dose 2 — Pfizer-BioNTech
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Concussion, Office visit, Syncope — Feeling: Fair · Headache · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Continuing to see a neurologist after concussion from fainting after the first dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Neurology

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Survey response — day 7, dose 2
MedDRA: Concussion, Syncope — Feeling: Fair · Headache, Fatigue or tiredness · 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

Free text: Still recovering from concussion after fainting from first shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Call 1 — Could Not Reach Participant
2021-10-26
Call 2 — Could Not Reach Participant
2022-04-11
Survey response — 12 months, dose 2
MedDRA: Heavy menstrual bleeding, Sciatica — 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: Heavy menstruation (never experienced before now) and painful sciatica

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
Report sent to call center — 12 months, 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)
2022-04-12
Callback requested for
09:00AM ET
2022-04-14
Call 1 — Requested Callback
2022-04-15
Call 2 — Could Not Reach Participant
2022-04-20
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Pfizer-BioNTech
2	2021-04-08	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-20	Unsuccessful
2021-03-27	Unsuccessful
2021-04-12	Successful	Does not wish to fill out VAERS report
2021-04-13	Successful	Does not wish to fill out VAERS report
2021-04-17	Successful	Does not wish to fill out VAERS report
2022-04-11	Successful 2022-04-20	Does not wish to fill out VAERS report

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Dizziness, fainted after the shot when administered yesterday

2021-03-18

Systemic reaction (other): Dizziness

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Persistent dizziness and ringing in ears (especially left ear). Feeling of fullness. Has been going on for a week but I didnt type it out when the other symptoms were more noticeable

Release 6 — day 14, dose 1

2021-03-27

Symptoms: Experiencing post concussive syndrome after fainting following receipt of the first dose of the vaccine.

Release 7 — days 1–6 daily, dose 2

2021-04-12

Healthcare visit (other): Continuing to see a neurologist after concussion from fainting after the first dose

2021-04-13

Healthcare visit (other): Neurology

Release 7 — day 7, dose 2

2021-04-17

Systemic reaction (other): Still recovering from concussion after fainting from first shot

Release 11 — 12 months, dose 2

2022-04-11

Symptoms: Heavy menstruation (never experienced before now) and painful sciatica

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	Concussion	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Syncope	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Post concussion syndrome	✓	✓	✓
SD	Sciatica	·	·	✓
SD	Syncope	✓	✓	✓
SRO	Concussion	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Syncope	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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