Y6J-15789-82021

2 vaccinations 12 coded responses 24 check-ins 12 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 921 / CA
Registered: 2021-08-28

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

2021-08-28
Registered in v-safe
2021-08-28
Dose 1 — Pfizer-BioNTech
2021-08-28
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Just got shot 1 hour ago

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Survey response — days 1–6 daily, dose 1
MedDRA: Arrhythmia, Chest discomfort, Chest pain, Cough, Emergency care, Extrasystoles — Feeling: Poor · Site: Pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Woke up with heart rhythm off. Heart skipping sensation then coughing. A few stabs in left of center chest. Went to Scripps ER this morning no AFIB or heart attack. Chest X-ray normal and blood work. Released to go home follow up with my cardiologist · Healthcare visit (other): Heart skipping/ chest discomfort following up with my cardiologist and heart monitor to be issued this werk

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-30
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiac flutter, Emergency care, Unevaluable event — Feeling: Poor · Site: Pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Heart rhythm · Healthcare visit (other): Strong heart flipping today, ER doctor having me start taking Cardizem daily and follow up with cardiologist on 9/10/01

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-09-01
Survey response — days 1–6 daily, dose 1
MedDRA: Arrhythmia, Palpitations — Feeling: Fair · Headache

Free text: Heart still flipping, (rhythm)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiac flutter — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Flipping heart

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-02
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 1 — Left Voicemail
2021-09-04
Survey response — day 7, dose 1
MedDRA: Cardiac flutter, Palpitations — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Slight heart flipping/racing

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-07
Call 1 — Left Voicemail
2021-09-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-09-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-09-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-10-04
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-10-10
Dose 2 — Pfizer-BioNTech
2021-10-10
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Just got 2nd vaccine this morning at 11:00 am

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Cramping in toes both feet yesterday

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Last night until 8:00 am above symptoms were very bad. Mid morning things eased

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Nausea

Adult check-in
2021-10-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-10-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-10-24
Survey response — day 14, dose 2
MedDRA: Bronchitis, Dyspnoea, Emergency care, Illness, Palpitations, SARS-CoV-2 test negative — Feeling: Poor · 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: Went to ER yesterday diagnosed with Bronchitis. Heart racing this week most likely from illness and shortness of breath Neg covid test,

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Report sent to call center — day 14, dose 2
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)
2021-10-26
Call 1 — Left Voicemail
2021-10-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-11-16
Survey response — day 35, dose 2
MedDRA: Cough, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Reoccurring cough · Healthcare visit (other): Primary dr follow up

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-17
Call 1 — Left Voicemail
2022-01-10
Survey response — 3 months, dose 2
MedDRA: Cough, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Continuing cough since second covid shot · Healthcare visit (other): In person visit with Pulmary doctor

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-28	Pfizer-BioNTech	No
2	2021-10-10	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-29	Successful	Participant prefers to complete VAERS report online
2021-08-30	Successful	Participant prefers to complete VAERS report online
2021-09-02	Successful	Participant prefers to complete VAERS report online
2021-10-24	Successful 2021-10-26	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-16	Unsuccessful
2022-01-10	Unsuccessful

Free text

Release 9 — day 0, dose 1

2021-08-28

Systemic reaction (other): Just got shot 1 hour ago

Release 9 — days 1–6 daily, dose 1

2021-08-29

Systemic reaction (other): Woke up with heart rhythm off. Heart skipping sensation then coughing. A few stabs in left of center chest. Went to Scripps ER this morning no AFIB or heart attack. Chest X-ray normal and blood work. Released to go home follow up with my cardiologist cut off by CDC

Healthcare visit (other): Heart skipping/ chest discomfort following up with my cardiologist and heart monitor to be issued this werk

2021-08-30

Systemic reaction (other): Heart rhythm

Healthcare visit (other): Strong heart flipping today, ER doctor having me start taking Cardizem daily and follow up with cardiologist on 9/10/01

2021-09-01

Systemic reaction (other): Heart still flipping, (rhythm)

2021-09-02

Systemic reaction (other): Flipping heart

Release 9 — day 7, dose 1

2021-09-04

Systemic reaction (other): Slight heart flipping/racing

Release 10 — day 0, dose 2

2021-10-10

Systemic reaction (other): Just got 2nd vaccine this morning at 11:00 am

Release 10 — days 1–6 daily, dose 2

2021-10-11

Systemic reaction (other): Cramping in toes both feet yesterday

2021-10-12

Systemic reaction (other): Last night until 8:00 am above symptoms were very bad. Mid morning things eased

Release 10 — day 14, dose 2

2021-10-24

Symptoms: Went to ER yesterday diagnosed with Bronchitis. Heart racing this week most likely from illness and shortness of breath Neg covid test,

Release 10 — day 35, dose 2

2021-11-16

Symptoms: Reoccurring cough

Healthcare visit (other): Primary dr follow up

Release 10 — 3 months, dose 2

2022-01-10

Symptoms: Continuing cough since second covid shot

Healthcare visit (other): In person visit with Pulmary 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	Cardiac flutter	✓	·	✓
HCVO	Chest discomfort	✓	·	✓
HCVO	Emergency care	✓	·	✓
HCVO	Extrasystoles	✓	·	✓
HCVO	Office visit	·	·	✓
SD	Bronchitis	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Emergency care	·	·	✓
SD	Illness	·	·	✓
SD	Palpitations	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Arrhythmia	✓	·	✓
SRO	Cardiac flutter	✓	·	✓
SRO	Chest pain	✓	·	✓
SRO	Cough	✓	·	✓
SRO	Emergency care	✓	·	✓
SRO	Extrasystoles	✓	·	✓
SRO	Muscle spasms	·	·	✓
SRO	Palpitations	✓	·	✓
SRO	Unevaluable event	✓	·	✓

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