Z9N-22481-20790

3 vaccinations 6 coded responses 26 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 299 / SC
Registered: 2021-03-19

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

2021-03-19
Registered in v-safe
2021-03-19
Dose 1 — Pfizer-BioNTech
2021-03-19
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Muscle or body aches, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 1
Feeling: Poor

Adult check-in
2021-04-14
Dose 2 — Pfizer-BioNTech
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Fair

Free text: Nose runny then stopped up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Cough, Respiratory tract congestion, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nose is either stopped up or running. Head congestion causing cough and now full blown sinus infection. Trying to set up an appointment with a doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 21, dose 2
MedDRA: Cough, Facial discomfort, Increased viscosity of upper respiratory secretion, Productive cough — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: My head is stopped up I have thick drainage down the back of my throat cough is worse and productive getting green sputum out. Face pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 28, dose 2
MedDRA: Cough, Sinusitis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Developed a nasty sinus infection with a cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Device occlusion, Hypoaesthesia, Neck pain, Pain in extremity, Paraesthesia, Pre-existing disease, Withdrawal syndrome — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Pain Pump Catheter has become blocked throwing me into withdrawals along with increased neck pain radiating down my right arm causing tingling and numbness

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2021-10-15
Call 1 — Left Voicemail
2021-11-02
Dose 3 — Pfizer-BioNTech
2021-12-02
Call 2 — Left Voicemail
2021-12-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-14
Survey response — 12 months, dose 2
MedDRA: Device occlusion, Drug withdrawal syndrome, Surgery — 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, Emergency room or emergency department visit

Free text: Symptoms: My Medtronic Pain Pump Catheter became blocked inducing severe withdrawals from Baclofen and Morphine on 08/13/2021. I just had surgery to insert a new catheter in my spine and a new pump in my abdomen on 04/07/2022 · Healthcare visit (other): Outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-03
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-04
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Pfizer-BioNTech
2	2021-04-14	Pfizer-BioNTech
3	2021-11-02	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-13	Successful 2021-12-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-14	Successful 2022-04-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Nose runny then stopped up

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Nose is either stopped up or running. Head congestion causing cough and now full blown sinus infection. Trying to set up an appointment with a doctor

Release 8 — day 21, dose 2

2021-05-05

Symptoms: My head is stopped up I have thick drainage down the back of my throat cough is worse and productive getting green sputum out. Face pressure

Release 8 — day 28, dose 2

2021-05-12

Symptoms: Developed a nasty sinus infection with a cough

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: Pain Pump Catheter has become blocked throwing me into withdrawals along with increased neck pain radiating down my right arm causing tingling and numbness

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: My Medtronic Pain Pump Catheter became blocked inducing severe withdrawals from Baclofen and Morphine on 08/13/2021. I just had surgery to insert a new catheter in my spine and a new pump in my abdomen on 04/07/2022

Healthcare visit (other): Outpatient surgery

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	Cough	✓	✓	✓
SD	Device occlusion	·	·	✓
SD	Drug withdrawal syndrome	·	·	✓
SD	Facial discomfort	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Increased viscosity of upper respiratory secretion	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Withdrawal syndrome	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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