YQJ-26563-65317

4 vaccinations 15 coded responses 36 check-ins 15 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 331 / FL
Registered: 2021-01-14

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

Registered dependents

SJ8-16563-05911 Other · Female · 2021-08-07

Timeline

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Pfizer-BioNTech
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Neuralgia — Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: Neuropathic type pain in lower extremities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-04
Dose 2 — Pfizer-BioNTech
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Light-headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Good · Muscle or body aches

Free text: Back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Mood altered, Mood swings, Oliguria, Urine output decreased — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Low urine output; confusion, moodiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 2
MedDRA: Confusional state, Memory impairment, Nasal congestion, Rhinorrhoea, Urine output decreased — Feeling: Fair

Free text: Runny, stuffy nose, confusion, increased forgetfulness, decreased urinary output.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Back pain, Office visit, Pain in extremity, Urinary tract infection — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: UTI, trigger finger, back pain · Healthcare visit (other): Office visit with PMD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
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)
2021-06-10
Call 1 — Left Voicemail
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Aortic stenosis, Dyspnoea, Fatigue, Office visit — 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: Symptoms: Severe aortic stenosis with shortness of breath and fatigue with exertion · Healthcare visit (other): Specialist consult, cardiac Cath, possible TAVR

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
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)
2021-10-04
Dose 3 — Pfizer-BioNTech
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-10-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-10-11
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-10-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-03
Survey response — day 28, dose 3
MedDRA: Arthralgia, Burning sensation, Muscular weakness, Office visit, Peripheral coldness — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: leg weakness, burning, cold extremities, hip pain · Healthcare visit (other): Primary care physician

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-03
Call 2 — Could Not Reach Participant
2021-11-04
Call 2 — Could Not Reach Participant
2021-11-09
Call 3 — Could Not Reach Participant
2021-11-17
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-03
Survey response — 3 months, dose 3
MedDRA: Gastric haemorrhage, Haematological infection, Medical counselling, Physiotherapy, Pneumonia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Blood infection, pneumonia, Gastric bleed · Healthcare visit (other): Home health with IV infusions, physical therapy

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-04
Call 1 — Could Not Reach Participant
2022-01-07
Call 2 — Could Not Reach Participant
2022-04-04
Survey response — 6 months, dose 3
MedDRA: Cough, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-05
Call 1 — Left Voicemail
2022-04-29
Dose 4 — Pfizer-BioNTech
2022-05-19
Survey response — day 14, dose 4
MedDRA: Atrial fibrillation, Chest pain, Heart rate irregular, Inflammation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: A Fib, chest pain, irregular heart beats, autoimmune inflammation requiring Prednisone

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Report sent to call center — day 14, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-20
Call 1 — Left Voicemail
2022-06-12
Survey response — day 42, dose 4
MedDRA: Atrial fibrillation, Cardiac failure, Dyspnoea, Giant cell arteritis, Heart rate irregular, Medical counselling, Peripheral coldness — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Heart failure, AFib, irregular heart beats, temporal arteritis, SOB, cold extremities, · Healthcare visit (other): Pacemaker insertion, new meds, home health

MedDRA releases: 2024-11 · check-in free text available
2022-06-12
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-13
Call 2 — Left Voicemail
2022-06-13
Call 1 — Left Voicemail
2022-06-13
Call 1 — Left Voicemail
2022-06-13
Call 3 — Left Voicemail
2022-06-13
Call 2 — Left Voicemail
2022-06-13
Call 2 — Left Voicemail
2022-06-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Pfizer-BioNTech
2	2021-02-04	Pfizer-BioNTech
3	2021-10-04	Pfizer-BioNTech	No
4	2022-04-29	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-17	priority 2/3
2021-05-06	Unsuccessful
2021-08-07	Unsuccessful
2021-11-03	Unsuccessful
2022-01-03	Unsuccessful
2022-04-04	Unsuccessful
2022-05-19	Unsuccessful
2022-06-12	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Neuropathic type pain in lower extremities

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Light-headedness

2021-02-06

Systemic reaction (other): Back pain

2021-02-07

Systemic reaction (other): Back pain

2021-02-09

Systemic reaction (other): Low urine output; confusion, moodiness

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Tinnitus

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Runny, stuffy nose, confusion, increased forgetfulness, decreased urinary output.

Release 5 — day 28, dose 2

2021-03-04

Symptoms: Fatigued

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: UTI, trigger finger, back pain

Healthcare visit (other): Office visit with PMD

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Severe aortic stenosis with shortness of breath and fatigue with exertion

Healthcare visit (other): Specialist consult, cardiac Cath, possible TAVR

Release 10 — day 28, dose 3

2021-11-03

Symptoms: leg weakness, burning, cold extremities, hip pain

Healthcare visit (other): Primary care physician

Release 10 — 3 months, dose 3

2022-01-03

Symptoms: Blood infection, pneumonia, Gastric bleed

Healthcare visit (other): Home health with IV infusions, physical therapy

Release 11 — 6 months, dose 3

2022-04-04

Symptoms: Cough, runny nose

Release 11 — day 14, dose 4

2022-05-19

Symptoms: A Fib, chest pain, irregular heart beats, autoimmune inflammation requiring Prednisone

Release 12 — day 42, dose 4

2022-06-12

Symptoms: Heart failure, AFib, irregular heart beats, temporal arteritis, SOB, cold extremities,

Healthcare visit (other): Pacemaker insertion, new meds, home health

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	Medical counselling	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Physiotherapy	·	·	✓
SD	Aortic stenosis	✓	·	✓
SD	Arthralgia	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Back pain	✓	✓	✓
SD	Burning sensation	·	·	✓
SD	Cardiac failure	·	·	✓
SD	Chest pain	·	·	✓
SD	Confusional state	✓	✓	✓
SD	Cough	·	·	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastric haemorrhage	·	·	✓
SD	Giant cell arteritis	·	·	✓
SD	Haematological infection	·	·	✓
SD	Heart rate irregular	·	·	✓
SD	Inflammation	·	·	✓
SD	Memory impairment	✓	✓	✓
SD	Muscular weakness	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral coldness	·	·	✓
SD	Pneumonia	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SD	Urine output decreased	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Mood altered	✓	·	✓
SRO	Mood swings	○	✓	○
SRO	Neuralgia	✓	✓	✓
SRO	Oliguria	✓	·	✓
SRO	Tinnitus	✓	✓	✓
SRO	Urine output decreased	○	✓	○

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