YRH-69535-21126

4 vaccinations 10 coded responses 26 check-ins 9 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 793 / TX
Registered: 2021-01-07

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

2021-01-06
Dose 1 — Pfizer-BioNTech
2021-01-07
Registered in v-safe
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Slight sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-27
Dose 2 — Pfizer-BioNTech
2021-01-27
Health check-in — day 0, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pain in right eye.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Ocular discomfort — Feeling: Fair · Headache, Fatigue or tiredness

Free text: My eye is better. Pain less

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 7, dose 2
MedDRA: Eye disorder, Office visit — Feeling: Good · Joint pains · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Made Dr appointment to see about eyes · Healthcare visit (other): Appointment at eye docto

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-20
Survey response — day 21, dose 2
MedDRA: Eye disorder, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: I am having some trouble with my right eye. Called Dr for advice and have appointment next week · Healthcare visit (other): Phone visit with Dr

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-26
Survey response — day 28, dose 2
MedDRA: Back pain, Headache, Herpes zoster, Medical observation, Neuralgia, Pruritus — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: I have shingles . itching,headache,back pain on nerves, · Healthcare visit (other): Doctors office 2 times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-28
Survey response — 3 months, dose 2
MedDRA: Herpes zoster, Office visit, Visual impairment — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had some decline in .my vision. I also had singles for several weeks. Got eye exam and new glasses. Dr also gave me medicine for singles · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Call 2 — Could Not Reach Participant
2021-06-09
Call 3 — Could Not Reach Participant
2021-07-29
Survey response — 6 months, dose 2
MedDRA: Cough, Dyspnoea, Headache, Office visit, Pain, Pyrexia — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Running fever bad headache short winded. Bad cough. Aching all over · Healthcare visit (other): Went to Dr office for testing

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-29
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-05
Call 1 — Could Not Reach Participant
2021-08-10
Call successful
Participant prefers to complete VAERS report online
2021-12-28
Dose 3 — Pfizer-BioNTech
2022-01-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-09-28
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-04
Survey response — days 1–6 daily, dose 4
MedDRA: Hypotension — Feeling: Good

Free text: Blood pressure is a little low.

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-26
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-29
Survey response — 6 months, dose 4
MedDRA: Cystitis, Influenza virus test negative, Office visit, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-29
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-03-30
Call 1 — Could Not Reach Participant
2023-03-30
Call 1 — Could Not Reach Participant
2023-03-30
Call 1 — Could Not Reach Participant
2023-03-30
Call 1 — Could Not Reach Participant
2023-03-30
Call 1 — Could Not Reach Participant
2023-03-30
Call 1 — Could Not Reach Participant
2023-03-30
Call successful
Does not wish to fill out VAERS report
2023-03-30
Call successful
Does not wish to fill out VAERS report
2023-03-30
Call successful
Does not wish to fill out VAERS report
2023-03-30
Call successful
Does not wish to fill out VAERS report
2023-03-30
Call successful
Does not wish to fill out VAERS report
2023-03-30
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Pfizer-BioNTech
2	2021-01-27	Pfizer-BioNTech
3	2021-12-28	Pfizer-BioNTech	No
4	2022-09-28	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-01-28	Successful 2023-03-30	Does not wish to fill out VAERS report
2021-02-03	Successful 2023-03-30	Does not wish to fill out VAERS report
2021-02-20	Successful 2023-03-30	Does not wish to fill out VAERS report
2021-02-26	Successful 2023-03-30	Does not wish to fill out VAERS report
2021-04-28	Successful 2023-03-30	Does not wish to fill out VAERS report
2021-07-29	Successful 2021-08-10	Participant prefers to complete VAERS report online
2023-03-29	Successful 2023-03-30	Completed over the phone

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Slight sore throat

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Pain in right eye.

2021-01-30

Systemic reaction (other): My eye is better. Pain less

Release 3 — day 7, dose 2

2021-02-03

Systemic reaction (other): Made Dr appointment to see about eyes

Healthcare visit (other): Appointment at eye docto

Release 4 — day 21, dose 2

2021-02-20

Symptoms: I am having some trouble with my right eye. Called Dr for advice and have appointment next week

Healthcare visit (other): Phone visit with Dr

Release 4 — day 28, dose 2

2021-02-26

Symptoms: I have shingles . itching,headache,back pain on nerves,

Healthcare visit (other): Doctors office 2 times

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: I had some decline in .my vision. I also had singles for several weeks. Got eye exam and new glasses. Dr also gave me medicine for singles

Healthcare visit (other): Doctors office

Release 9 — 6 months, dose 2

2021-07-29

Symptoms: Running fever bad headache short winded. Bad cough. Aching all over

Healthcare visit (other): Went to Dr office for testing

Release 12 — days 1–6 daily, dose 4

2022-10-04

Systemic reaction (other): Blood pressure is a little low.

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	Medical observation	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Cough	✓	·	✓
SD	Cystitis	·	·	✓
SD	Dyspnoea	✓	·	✓
SD	Eye disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Influenza virus test negative	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	·	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Visual impairment	✓	✓	✓
SRO	Eye disorder	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Hypotension	·	·	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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