YES-20809-50455

3 vaccinations 10 coded responses 29 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 535 / WI
Registered: 2021-01-30

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Pfizer-BioNTech
2021-01-30
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Light headed for a few hours this a.m.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Flatulence — Feeling: Good · Diarrhea

Free text: Gassy with foil odor? More of a mild gassy somewhat loose bowel.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea — Feeling: Good · Diarrhea

Free text: Loose stool..moderate.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — day 7, dose 1
MedDRA: Diarrhoea — Feeling: Good · Diarrhea

Free text: Loose still is easing up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Pfizer-BioNTech
2021-02-27
Survey response — day 7, dose 2
MedDRA: Dizziness, Syncope — Feeling: Fair · Headache, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: A sense of fainting and dizziness in the nite in bed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Survey response — day 35, dose 2
MedDRA: Headache, Malaise, Office visit, Syncope — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Frequent headaches and feeling of off balance/ approaching fainting · Healthcare visit (other): Primary care physician and referrals to my cardio and a visit with a Neurologist for testing with each.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — 3 months, dose 2
MedDRA: Insomnia, Office visit, Urinary tract spasm — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Seemingly a bout of urinary spasms in the night. Could not sleep. · Healthcare visit (other): Have an OB/GYN apptmt on May 24th.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
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)
2021-08-21
Survey response — 6 months, dose 2
MedDRA: Headache, Mobility decreased, Neck pain, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Neck pain, loss of lateral neck movement and headache. Gradually improving over 2 weeks · Healthcare visit (other): Seeing PCP on Monday

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-25
Call 1 — Left Voicemail
2021-11-02
Dose 3 — Pfizer-BioNTech
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-14
Survey response — day 42, dose 3
MedDRA: Erythema, Fatigue, Flushing, Headache, Malaise, Pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Saturday a.m. Woke with red face/ cheeks and felt under the weather; slight headache, fatigue and some body aches. No fever but had moments of flushes as tho I did.

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-02
Survey response — 12 months, dose 3
MedDRA: Anxiety, Arthralgia, Condition aggravated, Fatigue, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have scleroderma and I think I'm in a flare up with sore Joints, intermittent fatigue and anxiety.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Pfizer-BioNTech
2	2021-02-20	Pfizer-BioNTech
3	2021-11-02	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-27	Unsuccessful
2021-05-22	Unsuccessful
2021-08-21	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Light headed for a few hours this a.m.

2021-02-04

Systemic reaction (other): Gassy with foil odor? More of a mild gassy somewhat loose bowel.

2021-02-05

Systemic reaction (other): Loose stool..moderate.

Release 3 — day 7, dose 1

2021-02-06

Systemic reaction (other): Loose still is easing up.

Release 4 — day 7, dose 2

2021-02-27

Systemic reaction (other): A sense of fainting and dizziness in the nite in bed.

Release 6 — day 35, dose 2

2021-03-27

Symptoms: Frequent headaches and feeling of off balance/ approaching fainting

Healthcare visit (other): Primary care physician and referrals to my cardio and a visit with a Neurologist for testing with each.

Release 8 — 3 months, dose 2

2021-05-22

Symptoms: Seemingly a bout of urinary spasms in the night. Could not sleep.

Healthcare visit (other): Have an OB/GYN apptmt on May 24th.

Release 9 — 6 months, dose 2

2021-08-21

Symptoms: Neck pain, loss of lateral neck movement and headache. Gradually improving over 2 weeks

Healthcare visit (other): Seeing PCP on Monday

Release 10 — day 42, dose 3

2021-12-14

Symptoms: Saturday a.m. Woke with red face/ cheeks and felt under the weather; slight headache, fatigue and some body aches. No fever but had moments of flushes as tho I did.

Release 12 — 12 months, dose 3

2022-11-02

Symptoms: I have scleroderma and I think I'm in a flare up with sore Joints, intermittent fatigue and anxiety.

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	Syncope	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Arthralgia	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Erythema	·	·	✓
SD	Fatigue	·	·	✓
SD	Flushing	·	·	✓
SD	Headache	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Mobility decreased	✓	·	✓
SD	Neck pain	✓	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Urinary tract spasm	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Syncope	✓	✓	✓

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