YT9-15769-63285

2 vaccinations 14 coded responses 24 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 105 / NY
Registered: 2021-04-09

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Pfizer-BioNTech
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety — Feeling: Fair

Free text: Anxious

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-30
Dose 2 — Pfizer-BioNTech
2021-04-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Light headed ness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Fatigue or tiredness

Free text: Buzzing in head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: I still have a buzzing in my head from the first vaccine shot. I thought it would go away but it still remains.

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: Head discomfort — Feeling: Good

Free text: Still buzzing head

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: Tinnitus — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Buzzing in head

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: Head discomfort — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Buzzing in head. Going to ent tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-05-14
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-21
Survey response — day 21, dose 2
MedDRA: Hypoaesthesia, Nausea, Tinnitus, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Not only tinnitus but also numbness on face and arm. Stomach is queasy. · Healthcare visit (other): Ent and a private doctors.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
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)
2021-05-28
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache, Hypoaesthesia, Ocular discomfort, Tinnitus — Feeling: Poor · Be unable to do your normal daily activities

Free text: Very bad headaches, more numbness in face, tinnitus, tired, now pressure back of my eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Survey response — day 35, dose 2
MedDRA: Dizziness, Ear discomfort, Head discomfort, Headache, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tinnitus, clogged ears, heavy head, headache now dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 42, dose 2
MedDRA: Dizziness, Headache, Tinnitus — Feeling: Poor · Be unable to work or attend school

Free text: More headaches, tinnitus not stopping, pressure in back of eyes, slight dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-30
Survey response — 3 months, dose 2
MedDRA: Conjunctivitis, Dizziness, Ear pain, Eye pain, Fatigue, Head discomfort, Ocular discomfort, Office visit, Palpitations, Vertigo — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Heavy headDizzinessVertigo 2xPressure back of eyesHigh pressure left eye and now normalVaccine did something to my eyes where I had conjunctivitis. See doctor I. Two weeks. My eyes hurt when I keep looking leftEar painVery tired No · Healthcare visit (other): Ent, primary doctor, another primary doctor, heart doctor because I had palpitations which I could not write above, a couple of weeks I will see a neurologist and eye doctor. Costing me a lot of money I donot have.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
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)
2021-08-11
Call 1 — Left Voicemail
2021-10-29
Survey response — 6 months, dose 2
MedDRA: Disturbance in attention, Head discomfort, Hypoaesthesia, Nausea, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: All symptoms are still present except the numbness face and arm. In addition I am feeling nauseous. My head feels so bad that now I am having a hard time concentrating at work. · Healthcare visit (other): Went in person to two medical doctors, neurologist,ENT, my eye fo tor and cardiologist. I owe 1500 dollars that I don't have.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
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)
2021-11-01
Call 1 — Left Voicemail
2022-04-30
Survey response — 12 months, dose 2
MedDRA: Brain fog, Cone dystrophy, Eye disorder, Fatigue, Loss of personal independence in daily activities, Personality change, Pre-existing disease, Tinnitus, Vertigo — Feeling: Fair · Be unable to do your normal daily activities

Free text: Allergies Eye issues - cones are affected now Vertigo is slightly present still Tinnitus remains with no change Brain fog still present Busy head is still present Very tired still This vaccine has affected my everyday life personality changed

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Pfizer-BioNTech
2	2021-04-30	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-21	Unsuccessful
2021-07-30	Unsuccessful
2021-10-29	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-15

Systemic reaction (other): Anxious

Release 8 — days 1–6 daily, dose 2

2021-05-01

Systemic reaction (other): Light headed ness

2021-05-02

Systemic reaction (other): Buzzing in head

2021-05-03

Systemic reaction (other): I still have a buzzing in my head from the first vaccine shot. I thought it would go away but it still remains.

2021-05-04

Systemic reaction (other): Still buzzing head

2021-05-05

Systemic reaction (other): Buzzing in head

2021-05-06

Systemic reaction (other): Buzzing in head. Going to ent tomorrow

Release 8 — day 21, dose 2

2021-05-21

Symptoms: Not only tinnitus but also numbness on face and arm. Stomach is queasy.

Healthcare visit (other): Ent and a private doctors.

Release 8 — day 28, dose 2

2021-05-28

Symptoms: Very bad headaches, more numbness in face, tinnitus, tired, now pressure back of my eyes

Release 8 — day 35, dose 2

2021-06-04

Symptoms: Tinnitus, clogged ears, heavy head, headache now dizziness.

Release 9 — day 42, dose 2

2021-06-11

Symptoms: More headaches, tinnitus not stopping, pressure in back of eyes, slight dizziness

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: Heavy headDizzinessVertigo 2xPressure back of eyesHigh pressure left eye and now normalVaccine did something to my eyes where I had conjunctivitis. See doctor I. Two weeks. My eyes hurt when I keep looking leftEar painVery tired No

Healthcare visit (other): Ent, primary doctor, another primary doctor, heart doctor because I had palpitations which I could not write above, a couple of weeks I will see a neurologist and eye doctor. Costing me a lot of money I donot have.

Release 10 — 6 months, dose 2

2021-10-29

Symptoms: All symptoms are still present except the numbness face and arm. In addition I am feeling nauseous. My head feels so bad that now I am having a hard time concentrating at work.

Healthcare visit (other): Went in person to two medical doctors, neurologist,ENT, my eye fo tor and cardiologist. I owe 1500 dollars that I don't have.

Release 11 — 12 months, dose 2

2022-04-30

Symptoms: Allergies Eye issues - cones are affected now Vertigo is slightly present still Tinnitus remains with no change Brain fog still present Busy head is still present Very tired still This vaccine has affected my everyday life personality changed

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	Palpitations	✓	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Cone dystrophy	·	·	✓
SD	Conjunctivitis	✓	·	✓
SD	Disturbance in attention	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Ear pain	✓	·	✓
SD	Eye disorder	·	·	✓
SD	Eye pain	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Nausea	✓	✓	✓
SD	Ocular discomfort	✓	·	✓
SD	Personality change	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Vertigo	✓	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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