YP7-99528-14839

2 vaccinations 6 coded responses 8 check-ins 6 free-text entries 5 call cases

Sex: Female
Age at first dose: 16-20
ZIP prefix: 483 / MI
Registered: 2021-06-17

Relationship: Child or adolescent in my care
Guardian: K9C-23757-96721
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-05-12
Dose 1 — Pfizer-BioNTech
2021-06-02
Dose 2 — Pfizer-BioNTech
2021-06-17
Registered in v-safe
2021-06-17
Survey response — day 14, dose 2, dependent
MedDRA: Eyelid margin crusting, Eyelid rash, Rash pruritic, Skin exfoliation, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Left Eyelid rash developed approximately one week after .. red around eyelid snd under. Appears crusty skin peels. Itchy Still there and spread to second eye after second dose. No products being used since started · Healthcare visit (other): Saw primary dr 6/9. Suggested Zyrtec. Not pink eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 14, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-19
Call 1 — Left Voicemail
2021-06-21
Call successful
Completed over the phone
2021-06-23
Survey response — day 21, dose 2, dependent
MedDRA: Erythema of eyelid, Eyelid irritation, Eyelid margin crusting, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Eye symptom is still there both eyelids red, irritated , crusty. Looks like left eye is spreading towards temple area. Going to dr again today for follow up · Healthcare visit (other): In person

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Report sent to call center — day 21, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Call 1 — Left Voicemail
2021-07-02
Survey response — day 28, dose 2, dependent
MedDRA: Eye disorder, Eye irritation, Ocular hyperaemia, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still eye issue. Its been over 40 days. .. red irritated both eyelids and under eye area. Drs on 6/26. Dermatologist on 7/2 prescribed eye cream Review in 2 weeks. We have removed all cleansers lotions shampoos etc no improvement · Healthcare visit (other): Dr spots and dermatologist on 7/2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — day 28, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-11
Survey response — day 35, dose 2, dependent
MedDRA: Eye irritation, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Follow up at dermatologist 7/2.. treating eyes irritation with a hydroquortzone steroid cream Follow up 7/19 Seems to be lessoning. Could it have been the 10 weeks of the rapid tests used every Monday to play a sport required by or c19 shot · Healthcare visit (other): Dermatologist appt. follow up 7/19

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Report sent to call center — day 35, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-13
Call successful
Completed over the phone
2021-07-19
Survey response — day 42, dose 2, dependent
MedDRA: Eye disorder, Office visit, Skin discolouration — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still seeing dermatologist for eye reaction. Steroid cream makes seeems to be working Will know more in a few days · Healthcare visit (other): In person dermatology spots

MedDRA releases: 2024-11 · check-in free text available
2021-07-19
Report sent to call center — day 42, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-21
Call 1 — Left Voicemail
2021-09-02
Health check-in — 3 months, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-01
Survey response — 6 months, dose 2, dependent
MedDRA: Headache, Nasopharyngitis, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school

Free text: Positive covid test Bad headache and felt like a very bad cold

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — 12 months, dose 2, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-12	Pfizer-BioNTech
2	2021-06-02	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-06-17	Successful 2021-06-21	Completed over the phone
2021-06-23	Successful	Completed over the phone
2021-07-02	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-07-11	Successful 2021-07-13	Completed over the phone
2021-07-19	Unsuccessful

Free text

Release 9 — day 14, dose 2, dependent

2021-06-17

Symptoms: Left Eyelid rash developed approximately one week after .. red around eyelid snd under. Appears crusty skin peels. Itchy Still there and spread to second eye after second dose. No products being used since started

Healthcare visit (other): Saw primary dr 6/9. Suggested Zyrtec. Not pink eye

Release 9 — day 21, dose 2, dependent

2021-06-23

Symptoms: Eye symptom is still there both eyelids red, irritated , crusty. Looks like left eye is spreading towards temple area. Going to dr again today for follow up

Healthcare visit (other): In person

Release 9 — day 28, dose 2, dependent

2021-07-02

Symptoms: Still eye issue. Its been over 40 days. .. red irritated both eyelids and under eye area. Drs on 6/26. Dermatologist on 7/2 prescribed eye cream Review in 2 weeks. We have removed all cleansers lotions shampoos etc no improvement

Healthcare visit (other): Dr spots and dermatologist on 7/2

Release 9 — day 35, dose 2, dependent

2021-07-11

Symptoms: Follow up at dermatologist 7/2.. treating eyes irritation with a hydroquortzone steroid cream Follow up 7/19 Seems to be lessoning. Could it have been the 10 weeks of the rapid tests used every Monday to play a sport required by or c19 shot

Healthcare visit (other): Dermatologist appt. follow up 7/19

Release 9 — day 42, dose 2, dependent

2021-07-19

Symptoms: Still seeing dermatologist for eye reaction. Steroid cream makes seeems to be working Will know more in a few days

Healthcare visit (other): In person dermatology spots

Release 10 — 6 months, dose 2, dependent

2021-12-01

Symptoms: Positive covid test Bad headache and felt like a very bad cold

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	Skin discolouration	·	·	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Erythema of eyelid	✓	✓	✓
SD	Eye disorder	✓	✓	✓
SD	Eye irritation	✓	✓	✓
SD	Eyelid irritation	✓	✓	✓
SD	Eyelid margin crusting	✓	✓	✓
SD	Eyelid rash	✓	✓	✓
SD	Headache	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Skin exfoliation	✓	✓	✓

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