ZDA-30528-51425

2 vaccinations 18 coded responses 20 check-ins 18 free-text entries 12 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 300 / GA
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Pfizer-BioNTech
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event, Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event, Unevaluable event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Good · Muscle or body aches

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 14, dose 1
MedDRA: Cough, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Night cough · Healthcare visit (other): Negative Covid test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-01
Dose 2 — Pfizer-BioNTech
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Unevaluable event — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Short of breath m · Healthcare visit (other): Chest x ray

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Pulmonary oedema — Feeling: Fair · Site: Swelling · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Fluid in both lungs · Healthcare visit (other): Pulmonologist visit

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

1 call case(s)
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Unevaluable event — Feeling: Poor · Site: Swelling · Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Short of breath · Healthcare visit (other): Scheduled hospitalization

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — day 7, dose 2
MedDRA: Dyspnoea, SARS-CoV-2 test — Feeling: Fair · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Short of breath, had a COVID test today · Healthcare visit (other): COVID test at the hospital since I will be admitted Thursday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-15
Survey response — day 14, dose 2
MedDRA: Aspiration, Cough, Fatigue, Office visit, Painful respiration — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: 1.4 L fluid was taken from my right lung, so I have pain when breathing deeply, coughing and fatigue. I see the pulmonologist Wednesday. · Healthcare visit (other): Also saw cardiologist

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
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-01
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Hospitalisation — Feeling: Poor · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Short of breath so I had my second thorocentesis at the hospital.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-09
Survey response — day 35, dose 2
MedDRA: Ascites, Dyspnoea, Peritonitis, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Peritonitis and ascites, SOB · Healthcare visit (other): CT with contrast, thorocentesis for RT and LT lungs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Survey response — day 42, dose 2
MedDRA: Pericardial effusion, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Pericardial effusion · Healthcare visit (other): For PET and other appointment for ECHO cardiographs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Call successful
Participant prefers to complete VAERS report online
2021-05-03
Survey response — 3 months, dose 2
MedDRA: Ascites, Myocardial oedema, Office visit, Pulmonary oedema — Feeling: Poor · 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, Hospitalization

Free text: Fluid around my heart, in my lungs and ascites since my second dose of vaccine. Specialists , most recently a cardio Thorasic surgeon, and an oncologist, have looked for every typical reason for the fluid in all of the wrong places.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — 3 months, 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)
2021-08-02
Call successful
Participant prefers to complete VAERS report online
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Hospitalisation, Pericardial effusion, Pleural effusion — 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 · Hospitalization

Free text: Symptoms: According to CT chest and abdomen completed August 2: increased pericardial effusion. 2) left lung pleural effusion, and a small decrease in right side pleural effusion. · Healthcare visit (other): Hospital in July for stress test and repeat echocardiogram at (b)(6)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
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

1 call case(s)
2021-10-19
Call 1 — Left Voicemail
2022-02-01
Survey response — 12 months, dose 2
MedDRA: Office visit, Pleural effusion — 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, Hospitalization

Free text: Symptoms: Bilateral pleural effusions continue · Healthcare visit (other): (b)(6)Clinic in (b)(6)

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
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 · Hospitalization · 1 call case(s)
2022-02-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Pfizer-BioNTech
2	2021-02-01	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-01-27	Successful	Participant prefers to complete VAERS report online
2021-02-03	Successful	Participant prefers to complete VAERS report online
2021-02-04	Successful	Participant prefers to complete VAERS report online
2021-02-05	Successful	Participant prefers to complete VAERS report online
2021-02-08	Successful	Participant prefers to complete VAERS report online
2021-02-15	Successful 2021-08-02	Participant prefers to complete VAERS report online
2021-03-01	Successful	Participant prefers to complete VAERS report online
2021-03-09	Successful	Participant prefers to complete VAERS report online
2021-03-17	Successful 2021-04-22	Participant prefers to complete VAERS report online
2021-05-03	Successful	Participant prefers to complete VAERS report online
2021-08-04	Unsuccessful
2022-02-01	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): No

2021-01-16

Systemic reaction (other): No

2021-01-17

Systemic reaction (other): No

2021-01-19

Systemic reaction (other): No

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): No

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Night cough

Healthcare visit (other): Negative Covid test

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Short of breath m

Healthcare visit (other): Chest x ray

2021-02-04

Systemic reaction (other): Fluid in both lungs

Healthcare visit (other): Pulmonologist visit

2021-02-05

Systemic reaction (other): Short of breath

Healthcare visit (other): Scheduled hospitalization

2021-02-06

Systemic reaction (other): Short of breath

Release 3 — day 7, dose 2

2021-02-08

Systemic reaction (other): Short of breath, had a COVID test today

Healthcare visit (other): COVID test at the hospital since I will be admitted Thursday

Release 4 — day 14, dose 2

2021-02-15

Symptoms: 1.4 L fluid was taken from my right lung, so I have pain when breathing deeply, coughing and fatigue. I see the pulmonologist Wednesday.

Healthcare visit (other): Also saw cardiologist

Release 4 — day 28, dose 2

2021-03-01

Symptoms: Short of breath so I had my second thorocentesis at the hospital.

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Peritonitis and ascites, SOB

Healthcare visit (other): CT with contrast, thorocentesis for RT and LT lungs

Release 5 — day 42, dose 2

2021-03-17

Symptoms: Pericardial effusion

Healthcare visit (other): For PET and other appointment for ECHO cardiographs

Release 8 — 3 months, dose 2

2021-05-03

Symptoms: Fluid around my heart, in my lungs and ascites since my second dose of vaccine. Specialists , most recently a cardio Thorasic surgeon, and an oncologist, have looked for every typical reason for the fluid in all of the wrong places.

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: According to CT chest and abdomen completed August 2: increased pericardial effusion. 2) left lung pleural effusion, and a small decrease in right side pleural effusion.

Healthcare visit (other): Hospital in July for stress test and repeat echocardiogram at (b)(6)

redacted (b)(6)

Release 11 — 12 months, dose 2

2022-02-01

Symptoms: Bilateral pleural effusions continue

Healthcare visit (other): (b)(6)Clinic in (b)(6)

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	Hospitalisation	✓	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
HCVO	SARS-CoV-2 test negative	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Ascites	✓	✓	✓
SD	Aspiration	✓	✓	✓
SD	Computerised tomogram abdomen abnormal	✓	·	✓
SD	Computerised tomogram thorax abnormal	✓	·	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Myocardial oedema	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Painful respiration	✓	✓	✓
SD	Pericardial effusion	✓	✓	✓
SD	Peritonitis	✓	✓	✓
SD	Pleural effusion	✓	·	✓
SD	Pulmonary oedema	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pulmonary oedema	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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