Y5A-36255-32043

1 vaccination 7 coded responses 11 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 774 / TX
Registered: 2021-03-01

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

2021-03-01
Registered in v-safe
2021-03-17
Dose 1 — Pfizer-BioNTech
2021-03-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Blood pressure increased, Hospitalisation — Feeling: Poor · Fatigue or tiredness · 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: Systemic reaction (other): Deadly blood pressure spike due to 1st shot. Hospitalization and rescue squad. I almost died · Healthcare visit (other): Danger zone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — days 1–6 daily, 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)
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Anaphylactic reaction, Emergency care, Medical counselling — Feeling: Poor · Site: Redness · Chills, Headache, Muscle or body aches, Fatigue or tiredness · 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: Systemic reaction (other): Anaphylaxis 2 trips to ER via rescue · Healthcare visit (other): 2 MD friends suggested seeing my MD i have appt Thu Dr (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — days 1–6 daily, 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)
2021-03-27
Survey response — day 7, dose 1
MedDRA: Emergency care, Haematoma — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Hematoma 2 visits to ER via rescue HELLO

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 14, dose 1
MedDRA: Anxiety, Disturbance in attention, Haematoma, Lethargy, Pain, Restlessness — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Hematoma on my left cheek is even larger and more painful . Still have body aches, anxiety, restless, lethargy and trouble focusing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 21, dose 1
MedDRA: Adverse reaction — 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: Multiple

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — day 21, 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)
2021-04-14
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-21
Health check-in — day 35, dose 1
Feeling: Poor

Adult check-in
2021-04-28
Survey response — day 42, dose 1
MedDRA: Fatigue, Haematoma — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Chronic fatigue Facial hematoma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — 3 months, dose 1
Feeling: Poor

Adult check-in
2021-09-15
Survey response — 6 months, dose 1
MedDRA: Office visit, Skin indentation — 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

Free text: Symptoms: Crater on my face · Healthcare visit (other): Many various doctor

MedDRA releases: 2024-11 · check-in free text available
2021-09-15
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-20	Unsuccessful
2021-03-23	Unsuccessful
2021-04-07	Unsuccessful
2021-09-15	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Deadly blood pressure spike due to 1st shot. Hospitalization and rescue squad. I almost died

Healthcare visit (other): Danger zone

2021-03-23

Systemic reaction (other): Anaphylaxis 2 trips to ER via rescue

Healthcare visit (other): 2 MD friends suggested seeing my MD i have appt Thu Dr (b)(6)

redacted (b)(6)

Release 6 — day 7, dose 1

2021-03-27

Systemic reaction (other): Hematoma 2 visits to ER via rescue HELLO

Release 6 — day 14, dose 1

2021-03-31

Symptoms: Hematoma on my left cheek is even larger and more painful . Still have body aches, anxiety, restless, lethargy and trouble focusing.

Release 7 — day 21, dose 1

2021-04-07

Symptoms: Multiple

Release 8 — day 42, dose 1

2021-04-28

Symptoms: Chronic fatigue Facial hematoma

Release 9 — 6 months, dose 1

2021-09-15

Symptoms: Crater on my face

Healthcare visit (other): Many various doctor

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	Hospitalisation	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
SD	Adverse reaction	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Disturbance in attention	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Haematoma	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Restlessness	✓	✓	✓
SD	Skin indentation	·	·	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Haematoma	✓	✓	✓

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