Z2N-10718-65323

3 vaccinations 12 coded responses 38 check-ins 12 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 064 / CT
Registered: 2021-01-23

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

2021-01-22
Dose 1 — Pfizer-BioNTech
2021-01-23
Registered in v-safe
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: These might be usual for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — day 14, dose 1
MedDRA: Contusion, Dizziness — Feeling: Good

Free text: I found a bruise on my forehead and cant remember hitting it but do remember some dizziness I experienced during the snowstorm. This has never happened before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-22
Dose 2 — Pfizer-BioNTech
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-15
Survey response — day 21, dose 2
MedDRA: Respiratory tract congestion, Sinus pain — Feeling: Fair

Free text: Sinus pain and congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 28, dose 2
MedDRA: Sinus pain — Feeling: Good

Free text: Sinuses are painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-23
Survey response — 6 months, dose 2
MedDRA: Dyspnoea exertional — 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: Out of breath when walking

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-23
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)
2021-08-30
Call 1 — Left Voicemail
2021-09-30
Dose 3 — Pfizer-BioNTech
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Fatigue or tiredness, Nausea

Adult check-in
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Nausea

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills

Adult check-in
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-07
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-14
Survey response — day 14, dose 3
MedDRA: Pancreatitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Pancreatitis

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-10-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-21
Survey response — day 21, dose 3
MedDRA: Pancreatic disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Worsening pancreatic symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-10-28
Survey response — day 28, dose 3
MedDRA: Urinary tract infection — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Uti

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Fatigue — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Diarrhea after I eat and extreme fatigue. Probably due to the antibiotic I was on.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — day 35, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-11
Survey response — day 42, dose 3
MedDRA: Abdominal pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Abdominal pain after eating.

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-12
Call 1 — Left Voicemail
2021-12-30
Survey response — 3 months, dose 3
MedDRA: Hospitalisation, Pancreatitis — 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: Continued pancreatitis. Was hospitalized a second time. Do not drink alcohol and never smoked.

MedDRA releases: 2024-11 · check-in free text available
2021-12-30
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-02
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-09-30
Survey response — 12 months, dose 3
MedDRA: Fall, Pelvic fracture — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Just related to a fall. Fractured pelvis.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Pfizer-BioNTech
2	2021-02-22	Pfizer-BioNTech
3	2021-09-30	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-23	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-14	Successful 2021-10-18	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-21	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-28	Successful 2021-11-02	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04	Successful 2021-11-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-11	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-30	Successful 2022-01-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-25

Systemic reaction (other): These might be usual for me.

Release 3 — day 14, dose 1

2021-02-05

Symptoms: I found a bruise on my forehead and cant remember hitting it but do remember some dizziness I experienced during the snowstorm. This has never happened before.

Release 5 — day 21, dose 2

2021-03-15

Symptoms: Sinus pain and congestion.

Release 6 — day 28, dose 2

2021-03-22

Symptoms: Sinuses are painful.

Release 9 — 6 months, dose 2

2021-08-23

Symptoms: Out of breath when walking

Release 10 — day 14, dose 3

2021-10-14

Symptoms: Pancreatitis

Release 10 — day 21, dose 3

2021-10-21

Symptoms: Worsening pancreatic symptoms

Release 10 — day 28, dose 3

2021-10-28

Symptoms: Uti

Release 10 — day 35, dose 3

2021-11-04

Symptoms: Diarrhea after I eat and extreme fatigue. Probably due to the antibiotic I was on.

Release 10 — day 42, dose 3

2021-11-11

Symptoms: Abdominal pain after eating.

Release 10 — 3 months, dose 3

2021-12-30

Symptoms: Continued pancreatitis. Was hospitalized a second time. Do not drink alcohol and never smoked.

Release 12 — 12 months, dose 3

2022-09-30

Symptoms: Just related to a fall. Fractured pelvis.

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	Abdominal pain	·	·	✓
SD	Contusion	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea exertional	✓	·	✓
SD	Fall	·	·	✓
SD	Fatigue	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Pancreatic disorder	·	·	✓
SD	Pancreatitis	·	·	✓
SD	Pelvic fracture	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus pain	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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