Z4C-14819-40459

2 vaccinations 11 coded responses 21 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 292 / SC
Registered: 2021-01-15

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Pfizer-BioNTech
2021-01-15
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Moderate Burning sensation at injection site

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 · Site: Pain · None

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Nausea

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Hot flush — Feeling: Fair

Free text: Dizziness, hot flashes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Pfizer-BioNTech
2021-02-05
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Nausea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Intermittent Dizziness with nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure increased, Decreased appetite, Dizziness — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work

Free text: Intermittent dizziness, loss of appetite, and elevated blood pressures

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Middle ear effusion, SARS-CoV-2 test negative, Vertigo — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work, 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: Systemic reaction (other): Severe Vertigo · Healthcare visit (other): COVID tested Neg, fluid buildup in both ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-12
Survey response — day 7, dose 2
MedDRA: Emergency care, Eustachian tube obstruction, Fall, Gait disturbance, Vertigo — Feeling: Poor · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Went to ER- BP 167/108, vertigo, fell down x1-unsteady gait, eustachian tubes congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Survey response — day 21, dose 2
MedDRA: Dizziness, Ear pain, Fatigue, Headache, Hypertension — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Severe Headaches, dizziness, ear pain, fatigue, higher blood pressures

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 28, dose 2
MedDRA: Eustachian tube disorder, Eye discharge, Middle ear effusion, Vertigo — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Vertigo, unstable BPs AGAIN- been controlled on Metoprolol 25mg now taking 125-150mg!! Having eustacian tube disorder- 2nd ER visit with fluid in Ears. Yesterday ER visit at (b)(6) hosp found L ear fluid and Left eye drainage and high bp! Im a RN!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 28, dose 2
Be unable to work · 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 35, dose 2
Feeling: Fair

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Pfizer-BioNTech
2	2021-02-05	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-02-11	Unsuccessful
2021-02-12	Unsuccessful
2021-03-05	Unsuccessful

Free text

Release 2 — day 0, dose 1

2021-01-15

Systemic reaction (other): Moderate Burning sensation at injection site

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Dizziness

2021-01-19

Systemic reaction (other): Dizziness, hot flashes

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Intermittent Dizziness with nausea

2021-02-07

Systemic reaction (other): Dizziness

2021-02-09

Systemic reaction (other): Dizziness

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Intermittent dizziness, loss of appetite, and elevated blood pressures

2021-02-11

Systemic reaction (other): Severe Vertigo

Healthcare visit (other): COVID tested Neg, fluid buildup in both ears

Release 4 — day 7, dose 2

2021-02-12

Systemic reaction (other): Went to ER- BP 167/108, vertigo, fell down x1-unsteady gait, eustachian tubes congestion

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Severe Headaches, dizziness, ear pain, fatigue, higher blood pressures

Release 5 — day 28, dose 2

2021-03-05

Symptoms: Vertigo, unstable BPs AGAIN- been controlled on Metoprolol 25mg now taking 125-150mg!! Having eustacian tube disorder- 2nd ER visit with fluid in Ears. Yesterday ER visit at (b)(6) hosp found L ear fluid and Left eye drainage and high bp! Im a RN!! cut off by CDC

redacted (b)(6)

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	Middle ear effusion	✓	✓	✓
HCVO	SARS-CoV-2 test negative	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Eustachian tube disorder	✓	✓	✓
SD	Eye discharge	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Middle ear effusion	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Eustachian tube obstruction	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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