Y8Q-29556-38340

3 vaccinations 6 coded responses 16 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 948 / CA
Registered: 2021-02-07

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-17
Dose 1 — Pfizer-BioNTech
2021-02-07
Registered in v-safe
2021-02-07
Dose 2 — Pfizer-BioNTech
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal distension, Abdominal pain, Flatulence, Gastrointestinal disorder — Feeling: Poor · Be unable to do your normal daily activities

Free text: Intestinal issue. Gas and blotting, pain from upper to lower intestine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Survey response — day 7, dose 2
MedDRA: Pruritus, Self-medication — Feeling: Good · Site: Itching

Free text: I put my Cloridine patch on the same arm as vaccine and that caused the itch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-07
Survey response — day 28, dose 2
MedDRA: Musculoskeletal stiffness, Pain — Feeling: Fair

Free text: Pain and stiffness in neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-08
Survey response — 6 months, dose 2
MedDRA: Blood pressure increased, Headache, Hypertension, Pre-existing disease, Sinus congestion — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Higher blood pressure then usual. Have had my medication changed twice since June. Sickening headaches and sinus congestion.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-08
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-26
Dose 3 — Pfizer-BioNTech
Co-administered: Do not remember
2021-11-24
Call 2 — Left Voicemail
2022-02-07
Survey response — 12 months, dose 2
MedDRA: Cardiac disorder, Cardiomegaly, Intracardiac thrombus, Pulmonary hypertension, Telemedicine — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Severe Pulmonary Hypertension; blood clots in heart; enlarged heart and problems with heart pumping blood to lungs. · Healthcare visit (other): Video visits

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-02-08
Call 1 — Left Voicemail
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Hepatic infection — 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, Emergency room or emergency department visit

Free text: Hip pain; infection in liver.

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-10-31
Call 1 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Pfizer-BioNTech
2	2021-02-07	Pfizer-BioNTech
3	2021-10-26	Pfizer-BioNTech	Do not remember

Call center

Reported	Outcome	VAERS-related outcome
2021-08-08	Unsuccessful
2022-02-07	Unsuccessful
2022-10-28	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-09

Systemic reaction (other): Intestinal issue. Gas and blotting, pain from upper to lower intestine.

Release 4 — day 7, dose 2

2021-02-14

Systemic reaction (other): I put my Cloridine patch on the same arm as vaccine and that caused the itch.

Release 5 — day 28, dose 2

2021-03-07

Symptoms: Pain and stiffness in neck.

Release 9 — 6 months, dose 2

2021-08-08

Symptoms: Higher blood pressure then usual. Have had my medication changed twice since June. Sickening headaches and sinus congestion.

Release 11 — 12 months, dose 2

2022-02-07

Symptoms: Severe Pulmonary Hypertension; blood clots in heart; enlarged heart and problems with heart pumping blood to lungs.

Healthcare visit (other): Video visits

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: Hip pain; infection in liver.

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	Telemedicine	·	·	✓
SD	Arthralgia	·	·	✓
SD	Blood pressure increased	✓	·	✓
SD	Cardiac disorder	·	·	✓
SD	Cardiomegaly	·	·	✓
SD	Headache	✓	·	✓
SD	Hepatic infection	·	·	✓
SD	Hypertension	✓	·	✓
SD	Intracardiac thrombus	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Pulmonary hypertension	·	·	✓
SD	Sinus congestion	✓	·	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Gastrointestinal disorder	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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