YVC-19833-95587

3 vaccinations 5 coded responses 24 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 349 / FL
Registered: 2021-01-11

Relationship: Self
Race: Black or African American
Ethnicity: N/A

Timeline

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

2021-01-11
Registered in v-safe
2021-01-11
Dose 1 — Pfizer-BioNTech
2021-01-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Muscle or body aches

Free text: I take a biologic for rheumatoid. I am delaying my infusion in order for the vaccine to provide my immune system to build from the vaccine my infusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains

Free text: Not taking my biologic at this time. So my hand is a little stiff.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Pfizer-BioNTech
2021-02-01
Survey response — day 0, dose 2
MedDRA: Influenza like illness — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Diarrhea

Free text: Flu like feelibg

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-08
Survey response — day 7, dose 2
MedDRA: Acquired oesophageal web, Cough, Increased upper airway secretion, Office visit — Feeling: Good · Fatigue or tiredness

Free text: Lots of mucus in throat since the GI doctor saw it with a camera. I believe that I had Covid-19 in Dec Dec, 2019. February, 2020 coughing for weeks caused an esophageal web. On antibiotics now, because of the abundance of mucus. Felt that I should share this .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 6 months, dose 2
MedDRA: Brain operation, Subdural haematoma — Feeling: Fair · Be unable to work or attend school, 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: Recovering from a bilateral subdural hematoma -- brain operations. People that I know said my hematoma was the result of the Pfizer Vaccine. I don't believe this. But some of those people are using that rumor from not getting vaccinated. Contact me.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-13
Call 1 — Left Voicemail
2021-08-13
Call successful
Participant prefers to complete VAERS report online
2021-10-01
Dose 3 — Pfizer-BioNTech
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Pfizer-BioNTech
2	2021-02-01	Pfizer-BioNTech
3	2021-10-01	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-02	Successful 2021-08-13	Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): I take a biologic for rheumatoid. I am delaying my infusion in order for the vaccine to provide my immune system to build from the vaccine my infusion

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Not taking my biologic at this time. So my hand is a little stiff.

Release 3 — day 0, dose 2

2021-02-01

Systemic reaction (other): Flu like feelibg

Release 3 — day 7, dose 2

2021-02-08

Systemic reaction (other): Lots of mucus in throat since the GI doctor saw it with a camera. I believe that I had Covid-19 in Dec Dec, 2019. February, 2020 coughing for weeks caused an esophageal web. On antibiotics now, because of the abundance of mucus. Felt that I should share this .

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: Recovering from a bilateral subdural hematoma -- brain operations. People that I know said my hematoma was the result of the Pfizer Vaccine. I don't believe this. But some of those people are using that rumor from not getting vaccinated. Contact me. cut off by CDC

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
SD	Brain operation	✓	·	✓
SD	Subdural haematoma	✓	·	✓
SRO	Acquired oesophageal web	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Endoscopy abnormal	○	○	○
SRO	Increased upper airway secretion	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Medical observation	○	○	○
SRO	Office visit	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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