Y4E-16608-68076

3 vaccinations 11 coded responses 25 check-ins 11 free-text entries 9 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 591 / MT
Registered: 2020-12-17

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

2020-12-17
Registered in v-safe
2020-12-17
Dose 1 — Pfizer-BioNTech
2020-12-17
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-18
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2020-12-20
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-20
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2020-12-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2020-12-26
Survey response — day 7, dose 1
MedDRA: Mania — Feeling: Fair · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea

Free text: Manic. I had Covid sept 30th and I feel like I felt with positive test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Survey response — day 14, dose 1
MedDRA: Blood potassium decreased, Electrolyte substitution therapy, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities

Free text: Low potassium even on potassium replacement. I had a positive COVID test 9/30/2020 and am still not back to 100%

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Dose 2 — Pfizer-BioNTech
2021-01-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-07
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Vision blurred — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy, blurry vision, feel like I'm floating in space when sitting still

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Vision blurred — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Dizzy, blurry vision, feel weird off and on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-12
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Erythema, Joint swelling, Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · 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: Systemic reaction (other): Elbow on the arm where I got both Covid vaccines is red, swollen, painful · Healthcare visit (other): Could only get an appt. with PCP tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
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)
2021-01-13
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, 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: Bruised elbow and swelling on right arm where I got both vaccine doses

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, 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)
2021-01-16
Survey response — day 7, dose 2
MedDRA: Occupational exposure to SARS-CoV-2, SARS-CoV-2 test negative — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea

Free text: Symptoms a few days ago as an RN, I was tested for COVID but it was negative

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-01-28
Survey response — day 21, dose 2
MedDRA: Erythema, Lymphadenopathy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: On the arm where I had both vaccines, there is swelling and redness in my arm pit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Survey response — day 28, dose 2
MedDRA: Cyst removal — 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: Cyst in my arm that was growing, infected and removed on Monday. My WBC count is 3.3 and neutrophils are 1.1, which is new post second vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-02-23
Call 1 — Left Voicemail
2021-02-26
Call successful
Participant prefers to complete VAERS report online
2021-04-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-29
Call 1 — Left Voicemail
2021-07-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Pfizer-BioNTech
2022-01-07
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-29
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-17	Pfizer-BioNTech
2	2021-01-07	Pfizer-BioNTech
3	2021-10-29	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2020-12-18	Successful	Participant prefers to complete VAERS report online
2020-12-20	Successful	Participant prefers to complete VAERS report online
2020-12-31	Successful	Participant prefers to complete VAERS report online
2021-01-08	Successful	Participant prefers to complete VAERS report online
2021-01-09	Successful	Participant prefers to complete VAERS report online
2021-01-12	Successful	Participant prefers to complete VAERS report online
2021-01-13	Successful	Participant prefers to complete VAERS report online
2021-01-28	Successful 2021-02-26	Participant prefers to complete VAERS report online
2021-02-04	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-18

Systemic reaction (other): Sore throat

2020-12-20

Systemic reaction (other): Sore throat

Release 1 — day 7, dose 1

2020-12-26

Systemic reaction (other): Manic. I had Covid sept 30th and I feel like I felt with positive test

Release 1 — day 14, dose 1

2020-12-31

Symptoms: Low potassium even on potassium replacement. I had a positive COVID test 9/30/2020 and am still not back to 100%

Release 1 — days 1–6 daily, dose 2

2021-01-08

Systemic reaction (other): Dizzy, blurry vision, feel like I'm floating in space when sitting still

2021-01-09

Systemic reaction (other): Dizzy, blurry vision, feel weird off and on

2021-01-12

Systemic reaction (other): Elbow on the arm where I got both Covid vaccines is red, swollen, painful

Healthcare visit (other): Could only get an appt. with PCP tomorrow

2021-01-13

Systemic reaction (other): Bruised elbow and swelling on right arm where I got both vaccine doses

Release 2 — day 7, dose 2

2021-01-16

Systemic reaction (other): Symptoms a few days ago as an RN, I was tested for COVID but it was negative

Release 2 — day 21, dose 2

2021-01-28

Symptoms: On the arm where I had both vaccines, there is swelling and redness in my arm pit

Release 3 — day 28, dose 2

2021-02-04

Symptoms: Cyst in my arm that was growing, infected and removed on Monday. My WBC count is 3.3 and neutrophils are 1.1, which is new post second vaccine

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	Unevaluable event	✓	✓	✓
SD	Blood potassium decreased	✓	✓	✓
SD	Cyst removal	✓	✓	✓
SD	Electrolyte substitution therapy	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	SARS-CoV-2 test positive	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Contusion	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Injection related reaction	○	○	○
SRO	Joint swelling	✓	✓	✓
SRO	Mania	✓	✓	✓
SRO	Occupational exposure to SARS-CoV-2	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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