Y7G-19613-54779

5 vaccinations 8 coded responses 46 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 100 / NY
Registered: 2021-01-22

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

2021-01-21
Dose 1 — Pfizer-BioNTech
2021-01-22
Registered in v-safe
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Headache

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Pfizer-BioNTech
2021-02-18
Survey response — day 7, dose 2
MedDRA: Dizziness, Syncope — Feeling: Fair · Chills · Be unable to do your normal daily activities

Free text: Light headed and faint

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 14, dose 2
MedDRA: Cough — Feeling: Good

Free text: A dry cough which seems to be gone now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 21, dose 2
MedDRA: Blood potassium increased, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My blood potassium levels are too high. Even after being on low potassium diet for 5 weeks, it got higher. Going through series of blood and urine tests. · Healthcare visit (other): Primary Care doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 35, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cramps in calves of both legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-15
Dose 3 — Pfizer-BioNTech
2021-09-15
Survey response — day 0, dose 3
MedDRA: No adverse event — Feeling: Good · Site: Pain · Chills

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches

Adult check-in
2021-09-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-09-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-09-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-09-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-09-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-09-22
Survey response — day 7, dose 3
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: I had flu shot yesterday so pain in right arm not associated with booster shot

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-30
Call 2 — Left Voicemail
2021-10-06
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-31
Dose 4 — Pfizer-BioNTech
2022-04-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Survey response — 3 months, dose 4
MedDRA: Accident, Contusion, Office visit, Pain in extremity, Peripheral swelling — Feeling: Good · 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: Symptoms: A teen ran into me with his scooter, a month ago, and my leg is still swollen, hurting and bruised. Nothing related to COVID. · Healthcare visit (other): Also saw orthopedic and primary care doctors. Might need sonogram since leg still swollen,

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-01
Call 1 — Left Voicemail
2022-07-01
Call 1 — Left Voicemail
2022-09-22
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-29
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2022-09-30
Health check-in — day 7, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-06
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-03
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-22
Survey response — 3 months, dose 5
MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test negative, Tooth infection — Feeling: Good · Be unable to work or attend school, 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: Dental infections. I was exposed to COVID on 1/29/22 and also on 1/13/22. PCR yesterday was negative but was told it might've been too early to test,

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Report sent to call center — 3 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-12-23
Call 3 — Left Voicemail
2022-12-23
Call 2 — Left Voicemail
2022-12-23
Call 1 — Left Voicemail
2023-03-23
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Pfizer-BioNTech
2	2021-02-11	Pfizer-BioNTech
3	2021-09-15	Pfizer-BioNTech	No
4	2022-03-31	Pfizer-BioNTech	No
5	2022-09-22	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-03-04	Unsuccessful
2022-06-30	Unsuccessful
2022-12-22	Unsuccessful

Free text

Release 4 — day 7, dose 2

2021-02-18

Systemic reaction (other): Light headed and faint

Release 4 — day 14, dose 2

2021-02-25

Symptoms: A dry cough which seems to be gone now.

Release 5 — day 21, dose 2

2021-03-04

Symptoms: My blood potassium levels are too high. Even after being on low potassium diet for 5 weeks, it got higher. Going through series of blood and urine tests.

Healthcare visit (other): Primary Care doctor

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Cramps in calves of both legs

Release 9 — day 0, dose 3

2021-09-15

Systemic reaction (other): No

Release 9 — day 7, dose 3

2021-09-22

Systemic reaction (other): I had flu shot yesterday so pain in right arm not associated with booster shot

Release 12 — 3 months, dose 4

2022-06-30

Symptoms: A teen ran into me with his scooter, a month ago, and my leg is still swollen, hurting and bruised. Nothing related to COVID.

Healthcare visit (other): Also saw orthopedic and primary care doctors. Might need sonogram since leg still swollen,

Release 12 — 3 months, dose 5

2022-12-22

Symptoms: Dental infections. I was exposed to COVID on 1/29/22 and also on 1/13/22. PCR yesterday was negative but was told it might've been too early to test,

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	Peripheral swelling	·	·	✓
SD	Accident	·	·	✓
SD	Blood potassium increased	✓	✓	✓
SD	Contusion	·	·	✓
SD	Cough	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Tooth infection	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Syncope	✓	✓	✓

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