Z9J-92982-31339

2 vaccinations 11 coded responses 23 check-ins 11 free-text entries 7 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 482 / MI
Registered: 2021-03-29

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

2021-03-28
Dose 1 — Pfizer-BioNTech
2021-03-29
Registered in v-safe
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Survey response — day 14, dose 1
MedDRA: Arthralgia, Joint swelling, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain/swelling & low grade fever this week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Dose 2 — Pfizer-BioNTech
2021-04-18
Survey response — day 0, dose 2
MedDRA: Eye pruritus, Lip pruritus, Nasal pruritus, Sneezing — Feeling: Poor · Site: Pain · Headache, Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Itching of eyes, nose, lips & Sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Sneezing, Tongue pruritus — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, 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 · Telehealth, virtual health, or email health consultation

Free text: Face & tongue itching, Sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
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)
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Sneezing — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itching, Sneezing - improved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pruritus, Pruritus — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itching of eyes & face, improved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pruritus, Nasal pruritus, Pruritus — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild itching eyes/ nose/ face, improved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Survey response — day 14, dose 2
MedDRA: Cough, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, 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: New cough - Dr thinks anaphylaxis from the vaccine triggered my asthma to worsen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Report sent to call center — day 14, 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)
2021-05-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — day 42, dose 2
MedDRA: Anaphylactic reaction, Asthma, Menstruation irregular, Pre-existing disease, Surgery, Uterine dilation and curettage — Feeling: Fair · Be unable to do your normal daily activities, 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: Symptoms: Uncontrolled menstrual bleeding w/recent cycles, became uncontrollable even with meds, so had a D&C w/ablation on 5/25... Had to wait until asthma exacerbation (triggered by Anaphylaxis to Dose #2 of Pfizer COVID-19 Vaccine) stabilized. · Healthcare visit (other): Surgery in hospital OR

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-18
Survey response — 3 months, dose 2
MedDRA: Endometrial ablation, Heavy menstrual bleeding, Surgery, Uterine dilation and curettage — 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: Symptoms: Uncontrollable menstrual bleeding. Eventually leading to a D&C and Endometrial ablation. · Healthcare visit (other): Surgery as above

MedDRA releases: 2024-11 · check-in free text available
2021-07-18
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-24
Call 1 — Left Voicemail
2021-10-17
Survey response — 6 months, dose 2
MedDRA: Foot fracture, Hypersensitivity — Feeling: Fair · Be unable to do your normal daily activities, 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: Foot Fracture, New/Unexplained Allergic Reaction

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-19
Call 1 — Could Not Reach Participant
2021-10-25
Call 2 — Left Voicemail
2021-11-02
Call successful
Participant prefers to complete VAERS report online
2022-04-20
Survey response — 12 months, dose 2
MedDRA: Drug hypersensitivity — Feeling: Good · 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: Got Evusheld Injections and had an Allergic Reaction to them.

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-21
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-28	Pfizer-BioNTech
2	2021-04-18	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-18	Successful	Participant prefers to complete VAERS report online
2021-04-19	Successful	Participant prefers to complete VAERS report online
2021-05-02	Successful	Participant prefers to complete VAERS report online
2021-05-30	Successful	Participant prefers to complete VAERS report online
2021-07-18	Successful	Participant prefers to complete VAERS report online
2021-10-17	Successful 2021-11-02	Participant prefers to complete VAERS report online
2022-04-20	Successful 2022-04-21	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 7 — day 14, dose 1

2021-04-11

Symptoms: Joint pain/swelling & low grade fever this week

Release 7 — day 0, dose 2

2021-04-18

Systemic reaction (other): Itching of eyes, nose, lips & Sneezing

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Face & tongue itching, Sneezing

2021-04-21

Systemic reaction (other): Itching, Sneezing - improved

2021-04-22

Systemic reaction (other): Itching of eyes & face, improved

2021-04-23

Systemic reaction (other): Mild itching eyes/ nose/ face, improved

Release 8 — day 14, dose 2

2021-05-02

Symptoms: New cough - Dr thinks anaphylaxis from the vaccine triggered my asthma to worsen

Release 8 — day 42, dose 2

2021-05-30

Symptoms: Uncontrolled menstrual bleeding w/recent cycles, became uncontrollable even with meds, so had a D&C w/ablation on 5/25... Had to wait until asthma exacerbation (triggered by Anaphylaxis to Dose #2 of Pfizer COVID-19 Vaccine) stabilized.

Healthcare visit (other): Surgery in hospital OR

Release 9 — 3 months, dose 2

2021-07-18

Symptoms: Uncontrollable menstrual bleeding. Eventually leading to a D&C and Endometrial ablation.

Healthcare visit (other): Surgery as above

Release 10 — 6 months, dose 2

2021-10-17

Symptoms: Foot Fracture, New/Unexplained Allergic Reaction

Release 11 — 12 months, dose 2

2022-04-20

Symptoms: Got Evusheld Injections and had an Allergic Reaction to them.

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	Surgery	✓	✓	✓
SD	Anaphylactic reaction	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Drug hypersensitivity	·	·	✓
SD	Endometrial ablation	·	·	✓
SD	Foot fracture	·	·	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Joint swelling	✓	✓	✓
SD	Menstruation irregular	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Uterine dilation and curettage	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Lip pruritus	✓	✓	✓
SRO	Nasal pruritus	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Tongue pruritus	✓	✓	✓

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