Y99-12152-40590

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 200 / DC
Registered: 2021-03-03

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Pfizer-BioNTech
2021-03-03
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Survey response — day 7, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Heart disease from 3 massive heart attacks, complex regional pain syndrome stage 3 type 1, sleep apnea, asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 14, dose 1
MedDRA: Cough, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Coughing up phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Dose 2 — Pfizer-BioNTech
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Blood cholesterol increased, Cardiac disorder, Complex regional pain syndrome, Depression, Hypertension, Post-traumatic stress disorder, Sleep apnoea syndrome — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Depression, Hypertension, Pre-existing disease, Sleep apnoea syndrome — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Asthma, Benign prostatic hyperplasia, Complex regional pain syndrome, Depression, Sleep apnoea syndrome — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 7, dose 2
MedDRA: Cough, Pre-existing disease, Productive cough — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Coughing phlegm, She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Joint swelling — Feeling: Poor · Be unable to do your normal daily activities

Free text: Shortness of breath, shoulder swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Survey response — day 42, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Productive cough, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities

Free text: Coughing up Phlegm, stuffy nose, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Cough — Feeling: Fair

Free text: Coughing

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Pfizer-BioNTech
2	2021-03-25	Pfizer-BioNTech

Free text

Release 5 — day 7, dose 1

2021-03-10

Systemic reaction (other): Heart disease from 3 massive heart attacks, complex regional pain syndrome stage 3 type 1, sleep apnea, asthma

Release 5 — day 14, dose 1

2021-03-19

Symptoms: Coughing up phlegm

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd

2021-03-28

Systemic reaction (other): She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

2021-03-29

Systemic reaction (other): She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

2021-03-30

Systemic reaction (other): She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

2021-03-31

Systemic reaction (other): She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): Coughing phlegm, She has complex regional pain syndrome, heart disease, asthma, sleep apnea, depression, chronic ptsd, hbp

Release 7 — day 14, dose 2

2021-04-08

Symptoms: Shortness of breath, shoulder swelling

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Coughing up Phlegm, stuffy nose, sore throat

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Coughing

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
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Unevaluable event	○	✓	○
SRO	Asthma	✓	✓	✓
SRO	Benign prostatic hyperplasia	✓	✓	✓
SRO	Blood cholesterol increased	✓	✓	✓
SRO	Cardiac disorder	✓	✓	✓
SRO	Complex regional pain syndrome	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Post-traumatic stress disorder	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Sleep apnoea syndrome	✓	✓	✓

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