Z34-26558-92042

2 vaccinations 11 coded responses 25 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 190 / PA
Registered: 2021-02-17

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

2021-02-17
Registered in v-safe
2021-02-17
Dose 1 — Pfizer-BioNTech
2021-02-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Feeling hot — Feeling: Fair · Site: Pain · Chills

Free text: Chills then hot but didnt feel fevered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — day 14, dose 1
MedDRA: Back pain, Chillblains, Nausea, Pre-existing disease — Feeling: Good · Be unable to work

Free text: Yesterday nausested and chills. Severe back pain. No fever. Slept most of day.Today I am fine. Normal back pain for me, no chills or fever, no nausea. Odd.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Dose 2 — Pfizer-BioNTech
2021-03-10
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Had shot 5 min ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pruritus, Taste disorder — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No rash, right knee to foot itched ridiculously last night. Whole calf beet red from scratching. No clear reason. Nothing tastes normal, has taste just not nirmal taste.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itching not related to vaccine site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — day 14, dose 2
MedDRA: Feeling abnormal, Pyrexia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: I have run a fever again, 2 days, and foggy. This is amost weekly since firts vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Survey response — day 21, dose 2
MedDRA: Feeling abnormal, Pyrexia — Feeling: Fair

Free text: Brain fogginess. Low grade fever 1 day. This seems to be weekly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 28, dose 2
MedDRA: Feeling abnormal, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Weekly fog and fever/digestive issues. Fever is very low grade. Brain fog is disruptive.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 35, dose 2
MedDRA: Fatigue, Feeling abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have tested positive for Epstein Barr.Still have ongoing fatigue and mental fog issues.I also tested positive for covid antibodies but that was expected i think.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Survey response — day 42, dose 2
MedDRA: Feeling abnormal — Feeling: Fair

Free text: Still have ongoing fogginess that is not normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-08
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-07
Call successful
Participant prefers to complete VAERS report online
2022-01-07
Call successful
Participant prefers to complete VAERS report online
2022-03-12
Survey response — 12 months, dose 2
MedDRA: Contusion, Diverticulitis, Gastrointestinal motility disorder, Pruritus, Scratch, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Since vaccine diverticulitis diagnosed and increased, extended episodes. Surgery now scheduled. Bowel symptoms are constant flux-diarrhea, constipation, explosive bowels. Dramatic bruising just from scratching an itch as though skin and vessels thi

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Pfizer-BioNTech
2	2021-03-10	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-24	Successful 2022-01-07	Participant prefers to complete VAERS report online
2021-04-14	Successful 2022-01-07	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-19

Systemic reaction (other): Chills then hot but didnt feel fevered

Release 5 — day 14, dose 1

2021-03-03

Symptoms: Yesterday nausested and chills. Severe back pain. No fever. Slept most of day.Today I am fine. Normal back pain for me, no chills or fever, no nausea. Odd.

Release 5 — day 0, dose 2

2021-03-10

Systemic reaction (other): Had shot 5 min ago

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): No rash, right knee to foot itched ridiculously last night. Whole calf beet red from scratching. No clear reason. Nothing tastes normal, has taste just not nirmal taste.

2021-03-14

Systemic reaction (other): Itching not related to vaccine site

Release 6 — day 14, dose 2

2021-03-24

Symptoms: I have run a fever again, 2 days, and foggy. This is amost weekly since firts vaccine.

Release 6 — day 21, dose 2

2021-03-31

Symptoms: Brain fogginess. Low grade fever 1 day. This seems to be weekly.

Release 7 — day 28, dose 2

2021-04-07

Symptoms: Weekly fog and fever/digestive issues. Fever is very low grade. Brain fog is disruptive.

Release 7 — day 35, dose 2

2021-04-14

Symptoms: I have tested positive for Epstein Barr.Still have ongoing fatigue and mental fog issues.I also tested positive for covid antibodies but that was expected i think.

Release 7 — day 42, dose 2

2021-04-21

Symptoms: Still have ongoing fogginess that is not normal

Release 11 — 12 months, dose 2

2022-03-12

Symptoms: Since vaccine diverticulitis diagnosed and increased, extended episodes. Surgery now scheduled. Bowel symptoms are constant flux-diarrhea, constipation, explosive bowels. Dramatic bruising just from scratching an itch as though skin and vessels thi 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	Back pain	✓	✓	✓
SD	Chillblains	✓	✓	✓
SD	Contusion	·	·	✓
SD	Diverticulitis	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Gastrointestinal motility disorder	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Scratch	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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