Z98-21013-83306

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 322 / FL
Registered: 2021-01-11

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

2021-01-11
Registered in v-safe
2021-01-11
Dose 1 — Pfizer-BioNTech
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Neck pain — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe neck pain all night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
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
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Poor · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Rapid pulse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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: Fair · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Dizziness, Fatigue, Malaise, Pain, Pyrexia — Feeling: Fair · Fatigue or tiredness

Free text: After I reported on Thursday I got very sick again. With chills aching fatigue and 101 fever. After that I was very lightheaded/dizzy for two days. And that was the second reaction to the shot I had on Monday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Survey response — day 14, dose 2
MedDRA: Fatigue, Malaise, Office visit, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Extreme fatigue after being sick twice with 201 fevers · Healthcare visit (other): Reg GP

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-22
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache, Neurological examination, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Very bad headaches and fatigue · Healthcare visit (other): I saw a neurologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Call 1 — Left Voicemail
2021-08-02
Survey response — 6 months, dose 2
MedDRA: Emergency care, Hospitalisation, Pulmonary thrombosis — 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: I went to the ER on June 24 at 1am. It was determined that I had many blood clots in my right lung. I was admitted and am being treated with Eliquis.

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 do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call 1 — Left Voicemail
2022-02-01
Survey response — 12 months, dose 2
MedDRA: Emergency care, Pulmonary thrombosis — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Last June I went to the hospital in the middle of the night as an emergency and it turned out to be many blood clots in my right lung. They were determined to be unprovoked and now I'm on Eliquis.

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Pfizer-BioNTech
2	2021-02-01	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-01-15	priority 2/3
2021-02-15	Unsuccessful
2021-02-22	Unsuccessful
2021-08-02	Unsuccessful
2022-02-01	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Severe neck pain all night

Release 3 — days 1–6 daily, dose 2

2021-02-02

Systemic reaction (other): Rapid pulse

2021-02-07

Systemic reaction (other): After I reported on Thursday I got very sick again. With chills aching fatigue and 101 fever. After that I was very lightheaded/dizzy for two days. And that was the second reaction to the shot I had on Monday.

Release 4 — day 14, dose 2

2021-02-15

Symptoms: Extreme fatigue after being sick twice with 201 fevers

Healthcare visit (other): Reg GP

Release 4 — day 21, dose 2

2021-02-22

Symptoms: Very bad headaches and fatigue

Healthcare visit (other): I saw a neurologist

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: I went to the ER on June 24 at 1am. It was determined that I had many blood clots in my right lung. I was admitted and am being treated with Eliquis.

Release 11 — 12 months, dose 2

2022-02-01

Symptoms: Last June I went to the hospital in the middle of the night as an emergency and it turned out to be many blood clots in my right lung. They were determined to be unprovoked and now I'm on Eliquis.

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	Neurological examination	○	✓	○
HCVO	Office visit	✓	✓	✓
SD	Emergency care	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	✓	·	✓
SD	Malaise	✓	✓	✓
SD	Pulmonary thrombosis	✓	·	✓
SD	Pyrexia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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