Y4F-17553-91402

4 vaccinations 10 coded responses 22 check-ins 10 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 063 / CT
Registered: 2021-02-16

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

2021-01-26
Dose 1 — Pfizer-BioNTech
2021-02-16
Registered in v-safe
2021-02-16
Dose 2 — Pfizer-BioNTech
2021-02-16
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Paraesthesia, Paraesthesia oral — Feeling: Good · Site: Itching

Free text: I had tingling in my left hand and my lips within a few minutes of receiving the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain · Abdominal pain

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Nausea

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Nausea

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: I would be interested in speaking with someone about a reaction I had 48 hours after the 1st dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Nausea

Adult check-in
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 35, dose 2
MedDRA: Arthralgia, Emergency care, Nausea, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Severe pain in left shoulder and arm and nausea. I went to emergency because of heart attack concern but it wasnt a cardiac event.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Office visit, Pre-existing disease — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Unrelated to Covid, but I had 40 mls of fluid removed from both of my knees yesterday. This was a reaction to a Synvisc injection from last Friday. · Healthcare visit (other): In person doctors office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
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)
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Dose 3 — Pfizer-BioNTech
2021-11-01
Call 1 — Requested Callback
2021-11-02
Callback requested for
08:00AM ET
2021-11-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-16
Survey response — 12 months, dose 2
MedDRA: Office visit, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Irinart tract infections · Healthcare visit (other): PCP

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-08
Dose 4 — Pfizer-BioNTech
2022-05-02
Survey response — day 21, dose 4
MedDRA: Hypoaesthesia, Office visit, Paraesthesia — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Numbness and tingling in both legs from my toes up to my knees. Started around the middle of February 2022. · Healthcare visit (other): Appt with a neurologist

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-05-03
Call 1 — Left Voicemail
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-05-06
Survey response — day 28, dose 4
MedDRA: Dysphagia, Oropharyngeal pain, Rhinorrhoea, Self-medication, Sneezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Extremely sore throat for 5 days. Very difficult to swallow. No fever. Occasional sneezing. Slight nasal discharge. · Healthcare visit (other): Pharmacy where I purchased lozenges and throat spray. I also gargled with salt water.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-10
Call 1 — Left Voicemail
2022-05-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-20
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Survey response — 3 months, dose 4
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Numbness and tingling that moved from my lower legs up through my arms and head.

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

Emergency room or emergency department visit · 1 call case(s)
2022-07-12
Call successful
Participant prefers to complete VAERS report online
2022-07-12
Call successful
Participant prefers to complete VAERS report online
2022-10-09
Survey response — 6 months, dose 4
MedDRA: Fall, Humerus fracture — 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

Free text: I fell and fractured the humerus in my left arm on 9/3/2022.

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Report sent to call center — 6 months, dose 4
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)
2022-10-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-08
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Pfizer-BioNTech
2	2021-02-16	Pfizer-BioNTech
3	2021-10-19	Pfizer-BioNTech	No
4	2022-04-08	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-05-19	Successful 2021-11-02	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-16	Successful	Not applicable - Accidental Reporting
2022-05-02	Successful 2022-05-03	Participant prefers to complete VAERS report online
2022-05-06	Successful 2022-07-12	Participant prefers to complete VAERS report online
2022-07-08	Successful 2022-07-12	Participant prefers to complete VAERS report online
2022-10-09	Successful 2022-10-10	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — day 0, dose 2

2021-02-16

Systemic reaction (other): I had tingling in my left hand and my lips within a few minutes of receiving the vaccine.

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): No

2021-02-21

Systemic reaction (other): I would be interested in speaking with someone about a reaction I had 48 hours after the 1st dose.

Release 6 — day 35, dose 2

2021-03-23

Symptoms: Severe pain in left shoulder and arm and nausea. I went to emergency because of heart attack concern but it wasnt a cardiac event.

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Unrelated to Covid, but I had 40 mls of fluid removed from both of my knees yesterday. This was a reaction to a Synvisc injection from last Friday.

Healthcare visit (other): In person doctors office visit

Release 11 — 12 months, dose 2

2022-02-16

Symptoms: Irinart tract infections

Healthcare visit (other): PCP

Release 11 — day 21, dose 4

2022-05-02

Symptoms: Numbness and tingling in both legs from my toes up to my knees. Started around the middle of February 2022.

Healthcare visit (other): Appt with a neurologist

Release 11 — day 28, dose 4

2022-05-06

Symptoms: Extremely sore throat for 5 days. Very difficult to swallow. No fever. Occasional sneezing. Slight nasal discharge.

Healthcare visit (other): Pharmacy where I purchased lozenges and throat spray. I also gargled with salt water.

Release 12 — 3 months, dose 4

2022-07-08

Symptoms: Numbness and tingling that moved from my lower legs up through my arms and head.

Release 12 — 6 months, dose 4

2022-10-09

Symptoms: I fell and fractured the humerus in my left arm on 9/3/2022.

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	Self-medication	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Dysphagia	·	·	✓
SD	Emergency care	✓	✓	✓
SD	Fall	·	·	✓
SD	Humerus fracture	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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