YAP-27892-06142

5 vaccinations 7 coded responses 31 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 232 / VA
Registered: 2021-02-01

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

2021-01-26
Dose 1 — Pfizer-BioNTech
2021-02-01
Registered in v-safe
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain

Free text: Within an hour of receiving the shot I experienced PVC's. I have had them off and on for 30 years, but not in the past year. I am still feeling at least 30 PVC's a day. I have notified my doctors and was advised to get this information to you. My primary care doctor suggested that I not get the second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — day 7, dose 1
MedDRA: Medical counselling, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: i am still experiencing PVC's. my primary care doctor has advised that i not get the second dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Pfizer-BioNTech
2021-02-16
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-23
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-18
Survey response — 3 months, dose 2
MedDRA: Office visit, Subretinal haematoma — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: retinal hematoma · Healthcare visit (other): appointment at doctor's office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-11
Call 1 — Left Voicemail
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-13
Dose 3 — Pfizer-BioNTech
2022-02-16
Survey response — 12 months, dose 2
MedDRA: Influenza like illness, Palpitations — Feeling: Good

Free text: after the booster i experienced flu like symptoms for 3 days. also, i feel my heart pounding, not racing or causing pain. this happens in the afternoon or night.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Dose 4 — Pfizer-BioNTech
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache

Adult check-in
2022-04-29
Survey response — day 7, dose 4
MedDRA: Chest pain — Feeling: Good · Headache

Free text: chest pain in the morning

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-15
Survey response — day 21, dose 4
MedDRA: Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: these are due to another condition

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-22
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Survey response — 6 months, dose 4
MedDRA: Nerve compression, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Pinched nerves in lumbar spine · Healthcare visit (other): Physical therapy

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Dose 5 — Pfizer-BioNTech
2023-04-28
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Pfizer-BioNTech
2	2021-02-16	Pfizer-BioNTech
3	2021-11-13	Pfizer-BioNTech	No
4	2022-04-22	Pfizer-BioNTech	No
5	2022-10-27	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-02	Successful 2021-11-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-18	Successful 2021-11-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-21	Successful 2022-10-24	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): Within an hour of receiving the shot I experienced PVC's. I have had them off and on for 30 years, but not in the past year. I am still feeling at least 30 PVC's a day. I have notified my doctors and was advised to get this information to you. My primary care doctor suggested that I not get the second shot.

Release 3 — day 7, dose 1

2021-02-02

Systemic reaction (other): i am still experiencing PVC's. my primary care doctor has advised that i not get the second dose.

Release 8 — 3 months, dose 2

2021-05-18

Symptoms: retinal hematoma

Healthcare visit (other): appointment at doctor's office

Release 11 — 12 months, dose 2

2022-02-16

Symptoms: after the booster i experienced flu like symptoms for 3 days. also, i feel my heart pounding, not racing or causing pain. this happens in the afternoon or night.

Release 11 — day 7, dose 4

2022-04-29

Systemic reaction (other): chest pain in the morning

Release 11 — day 21, dose 4

2022-05-15

Symptoms: these are due to another condition

Release 12 — 6 months, dose 4

2022-10-21

Symptoms: Pinched nerves in lumbar spine

Healthcare visit (other): Physical therapy

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	Physiotherapy	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Nerve compression	·	·	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Subretinal haematoma	✓	✓	✓
SRO	Chest pain	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Ventricular extrasystoles	✓	✓	✓

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