YBJ-29767-20018

2 vaccinations 12 coded responses 20 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 040 / ME
Registered: 2021-04-15

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

2021-04-10
Dose 1 — Pfizer-BioNTech
2021-04-15
Registered in v-safe
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary tract infection — Feeling: Fair · Abdominal pain · Be unable to do your normal daily activities

Free text: UTI symptoms since day after first dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pelvic pain — Feeling: Poor · Diarrhea · Be unable to do your normal daily activities

Free text: Pelvic pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 7, dose 1
MedDRA: Pelvic pain — Feeling: Fair · Abdominal pain · Be unable to do your normal daily activities

Free text: Pelvic pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Dose 2 — Pfizer-BioNTech
2021-05-01
Survey response — day 0, dose 2
MedDRA: Abdominal pain lower — Feeling: Fair · Site: Pain · Headache, Abdominal pain

Free text: Right lower abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain lower — Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness, Abdominal pain

Free text: Abdominal pain in lower right quadrant

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain lower — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Abdominal pain

Free text: Lower right abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia — Feeling: Fair · Headache, Abdominal pain

Free text: Heart burn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain lower — Feeling: Fair · Headache, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sharp lower right abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Diarrhea, Abdominal pain

Adult check-in
2021-05-08
Survey response — day 7, dose 2
MedDRA: Dyspepsia — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Heart burn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 14, dose 2
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Be unable to work, 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: I was diagnosed with two massive hemorrhagic cysts on my right ovary. One burst this week and caused an infection. I had a cat scan confirming this after suspected appendicitis. Symptoms of the cysts presented 3 days after first vaccine dose. · Healthcare visit (other): Two doctors visits, one ultrasound, one cat scan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-22
Survey response — day 21, dose 2
MedDRA: Abdominal pain lower, Pre-existing disease — 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

Free text: Lower right abdominal pain from hemorrhagic cyst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-31
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-07
Call successful
Does not wish to fill out VAERS report
2022-05-01
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: COVID-19 infection

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Pfizer-BioNTech
2	2021-05-01	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-15	Successful	Does not wish to fill out VAERS report
2021-05-22	Successful 2022-04-07	Does not wish to fill out VAERS report

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-15

Systemic reaction (other): UTI symptoms since day after first dose

2021-04-16

Systemic reaction (other): Pelvic pain

Release 7 — day 7, dose 1

2021-04-17

Systemic reaction (other): Pelvic pain

Release 8 — day 0, dose 2

2021-05-01

Systemic reaction (other): Right lower abdominal pain

Release 8 — days 1–6 daily, dose 2

2021-05-03

Systemic reaction (other): Abdominal pain in lower right quadrant

2021-05-04

Systemic reaction (other): Lower right abdominal pain

2021-05-05

Systemic reaction (other): Heart burn

2021-05-06

Systemic reaction (other): Sharp lower right abdominal pain

Release 8 — day 7, dose 2

2021-05-08

Systemic reaction (other): Heart burn

Release 8 — day 14, dose 2

2021-05-15

Symptoms: I was diagnosed with two massive hemorrhagic cysts on my right ovary. One burst this week and caused an infection. I had a cat scan confirming this after suspected appendicitis. Symptoms of the cysts presented 3 days after first vaccine dose.

Healthcare visit (other): Two doctors visits, one ultrasound, one cat scan

Release 8 — day 21, dose 2

2021-05-22

Symptoms: Lower right abdominal pain from hemorrhagic cyst

Release 11 — 12 months, dose 2

2022-05-01

Symptoms: COVID-19 infection

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	✓	✓	✓
SD	Abdominal pain lower	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Abdominal pain lower	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Pelvic pain	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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