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Z8U-69737-14021

2 vaccinations 17 coded responses 17 check-ins 17 free-text entries 3 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
651 / MO
Registered
2021-08-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-07-29
    Dose 1 — Pfizer-BioNTech
  2. 2021-08-02
    Registered in v-safe
  3. 2021-08-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Brain fog — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea
    Free text: Brain fog
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  4. 2021-08-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Rales — Feeling: Fair · Site: Pain · Chills, Joint pains, Diarrhea, Abdominal pain
    Free text: Cytokine lung vibrating
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  5. 2021-08-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chest discomfort, Feeling cold — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Diarrhea
    Free text: Tight chest cool feeling
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  6. 2021-08-05
    Survey response — day 7, dose 1
    MedDRA: Haemorrhagic diathesis, Medical counselling — Feeling: Fair · Site: Itching · Fever · Chills, Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional
    Free text: Systemic reaction (other): Easy bleeding- getting the von willibrands checked tomorrow · Healthcare visit (other): Called Dr to get test done.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  7. 2021-08-05
    Report sent to call center — day 7, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  8. 2021-08-12
    Survey response — day 14, dose 1
    MedDRA: Emergency care, Feeling cold, Hyperhidrosis, Nasopharyngitis, Palpitations, Sensory disturbance, Sneezing — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: This problem is a major cold doctors do not know about. Lungs got cold, legs lit up like a lightbulb, sneezed a lot sweat and heart palpitations. Went to ER and they did nothing. Dont want the second dose unless a doctor sees me weekly for a month
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  9. 2021-08-12
    Report sent to call center — day 14, dose 1
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-08-17
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  11. 2021-08-19
    Dose 2 — Pfizer-BioNTech
  12. 2021-08-19
    Survey response — day 0, dose 2
    MedDRA: Feeling cold — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Vomiting, Diarrhea
    Free text: Feel cold
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  13. 2021-08-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cytokine storm, Migraine — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Severe migraine cytokine reaction
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  14. 2021-08-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chest discomfort, Chest pain — Feeling: Fair · Chills, Muscle or body aches
    Free text: Chest tightness burning
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  15. 2021-08-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cytokine storm — Feeling: Fair · Site: Pain · Chills, Muscle or body aches
    Free text: Slight cytokine reaction,
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  16. 2021-08-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cytokine abnormal, Respiratory tract irritation — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea
    Free text: Burning in lungs and cytokine reaction - from the virus itself not from vaccine.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  17. 2021-08-26
    Survey response — day 7, dose 2
    MedDRA: Cough, Cytokine storm, Diarrhoea, Hyperhidrosis, Hypersensitivity, Influenza like illness, Paraesthesia, Pre-existing disease, Sneezing, Tremor — Feeling: Fair · Chills, Joint pains, Diarrhea, Abdominal pain
    Free text: Cytokine reaction - The bread allergy symptoms occurred with our eating bread. Flu like symptoms with diarrhea, shaking, sweating so there is something other than gluten intolerance going on. Cough,sneezing, lower legs vibrating. Strange symptoms
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  18. 2021-09-02
    Survey response — day 14, dose 2
    MedDRA: Meningism, Presyncope, Pulmonary pain, Toothache — Feeling: Poor
    Free text: I have Menningitis symptoms and it feels like sharp pains in back lungs and teeth. Almost passed out at work. Do not ever go get checked because they think everything is in eveyjnes head.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  19. 2021-09-11
    Survey response — day 21, dose 2
    MedDRA: Condition aggravated, Diarrhoea, Pre-existing disease — Feeling: Fair
    Free text: Its not from the vaccine! Its bovine gynecological mycoplasma and another lung condition when I had asthma but got rid of it by staying away from specific foods. The Brazil nut lung problem causing diarrheal
    MedDRA releases: 2024-11 · check-in free text available
  20. 2021-09-16
    Survey response — day 28, dose 2
    MedDRA: Diabetes mellitus, Pneumonia, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: In general I am better but it dislodged a pheumonia that is behind Diabetes. I have worked with patients on the ventelator. One problem is a severe paper allergy.
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-09-23
    Survey response — day 35, dose 2
    MedDRA: Chest discomfort, Chest pain, Dizziness, Dysgeusia, Feeling jittery, Gingival pain, Hypersensitivity, Pelvic pain, Pre-existing disease, Pulmonary pain, Skin odour abnormal — Feeling: Fair · Be unable to work or attend school
    Free text: Burning in lungs, chest and pelvic area. Jittery feeling, cow taste in mouth. Cold gums, cow smell coming out of skin, increase in food sensitivity, tightness in lungs, diarrhea. The vaccine is not the cause, it triggered it like some foods.
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-10-01
    Survey response — day 42, dose 2
    MedDRA: Seizure, Viral infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit
    Free text: Seizures and no doctor so ordering some herbs. Its an underlying virus that everyone has that will not get vaccines
    MedDRA releases: 2024-11 · check-in free text available
  23. 2021-10-01
    Report sent to call center — day 42, dose 2
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
  24. 2021-10-05
    Call successful
    Participant prefers to complete VAERS report online
  25. 2022-08-19
    Survey response — 12 months, dose 2
    MedDRA: Diarrhoea, Dysgeusia, Paraesthesia, Photophobia, Sneezing — Feeling: Fair · Be unable to do your normal daily activities
    Free text: A different type of diarrhea. It's related to a sneeze but no positive coved. A taste of calcium in my mouth. Have some trouble organizing paper or touching it. And photophobia. Just eat salad and very little animal protein.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-07-29Pfizer-BioNTech No
22021-08-19Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-08-05 Successful Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-12 Successful
2021-08-17
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-01 Successful
2021-10-05
 Participant prefers to complete VAERS report online

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-02

Systemic reaction (other): Brain fog

2021-08-03

Systemic reaction (other): Cytokine lung vibrating

2021-08-04

Systemic reaction (other): Tight chest cool feeling

Release 9 — day 7, dose 1

2021-08-05

Systemic reaction (other): Easy bleeding- getting the von willibrands checked tomorrow
Healthcare visit (other): Called Dr to get test done.

Release 9 — day 14, dose 1

2021-08-12

Symptoms: This problem is a major cold doctors do not know about. Lungs got cold, legs lit up like a lightbulb, sneezed a lot sweat and heart palpitations. Went to ER and they did nothing. Dont want the second dose unless a doctor sees me weekly for a month

Release 9 — day 0, dose 2

2021-08-19

Systemic reaction (other): Feel cold

Release 9 — days 1–6 daily, dose 2

2021-08-20

Systemic reaction (other): Severe migraine cytokine reaction

2021-08-22

Systemic reaction (other): Chest tightness burning

2021-08-23

Systemic reaction (other): Slight cytokine reaction,

2021-08-24

Systemic reaction (other): Burning in lungs and cytokine reaction - from the virus itself not from vaccine.

Release 9 — day 7, dose 2

2021-08-26

Systemic reaction (other): Cytokine reaction - The bread allergy symptoms occurred with our eating bread. Flu like symptoms with diarrhea, shaking, sweating so there is something other than gluten intolerance going on. Cough,sneezing, lower legs vibrating. Strange symptoms

Release 9 — day 14, dose 2

2021-09-02

Symptoms: I have Menningitis symptoms and it feels like sharp pains in back lungs and teeth. Almost passed out at work. Do not ever go get checked because they think everything is in eveyjnes head.

Release 9 — day 21, dose 2

2021-09-11

Symptoms: Its not from the vaccine! Its bovine gynecological mycoplasma and another lung condition when I had asthma but got rid of it by staying away from specific foods. The Brazil nut lung problem causing diarrheal

Release 9 — day 28, dose 2

2021-09-16

Symptoms: In general I am better but it dislodged a pheumonia that is behind Diabetes. I have worked with patients on the ventelator. One problem is a severe paper allergy.

Release 9 — day 35, dose 2

2021-09-23

Symptoms: Burning in lungs, chest and pelvic area. Jittery feeling, cow taste in mouth. Cold gums, cow smell coming out of skin, increase in food sensitivity, tightness in lungs, diarrhea. The vaccine is not the cause, it triggered it like some foods.

Release 9 — day 42, dose 2

2021-10-01

Symptoms: Seizures and no doctor so ordering some herbs. Its an underlying virus that everyone has that will not get vaccines

Release 12 — 12 months, dose 2

2022-08-19

Symptoms: A different type of diarrhea. It's related to a sneeze but no positive coved. A taste of calcium in my mouth. Have some trouble organizing paper or touching it. And photophobia. Just eat salad and very little animal protein.

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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling ✓ · ✓
SDChest discomfort · · ✓
SDChest pain · · ✓
SDCondition aggravated · · ✓
SDDiabetes mellitus · · ✓
SDDiarrhoea · · ✓
SDDizziness · · ✓
SDDysgeusia · · ✓
SDEmergency care ✓ · ✓
SDFeeling cold ✓ · ✓
SDFeeling jittery · · ✓
SDGingival pain · · ✓
SDHyperhidrosis ✓ · ✓
SDHypersensitivity · · ✓
SDMeningism ✓ · ✓
SDNasopharyngitis ✓ · ✓
SDPalpitations ✓ · ✓
SDParaesthesia · · ✓
SDPelvic pain · · ✓
SDPhotophobia · · ✓
SDPneumonia · · ✓
SDPre-existing disease · · ✓
SDPresyncope ✓ · ✓
SDPulmonary pain ✓ · ✓
SDSeizure · · ✓
SDSensory disturbance ✓ · ✓
SDSkin odour abnormal · · ✓
SDSneezing ✓ · ✓
SDToothache ✓ · ✓
SDViral infection · · ✓
SROBrain fog ✓ · ✓
SROChest discomfort ✓ · ✓
SROChest pain ✓ · ✓
SROCough ✓ · ✓
SROCytokine abnormal ✓ · ✓
SROCytokine storm ✓ · ✓
SRODiarrhoea ✓ · ✓
SROFeeling cold ✓ · ✓
SROHaemorrhagic diathesis ✓ · ✓
SROHyperhidrosis ✓ · ✓
SROHypersensitivity ✓ · ✓
SROInfluenza like illness ✓ · ✓
SROMigraine ✓ · ✓
SROParaesthesia ✓ · ✓
SROPre-existing disease ✓ · ✓
SRORales ✓ · ✓
SRORespiratory tract irritation ✓ · ✓
SROSneezing ✓ · ✓
SROTremor ✓ · ✓

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

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