ZQE-24626-26167 · OpenVSafe

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-20
Dose 1 — Pfizer-BioNTech
2021-02-04
Registered in v-safe
2021-02-04
Survey response — day 14, dose 1
MedDRA: Cerebrovascular accident, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative — 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: STROKE within 48 hours of receiving vaccine.(b)(6); 1/22-27/2021.Tested COVID antibody positive January 7, 2021.Tested COVID negative at that same time.Received vaccine in Assisted Living Facility on January 20, 2021.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Survey response — day 21, dose 1
MedDRA: Asthenia, Asthma, Loss of personal independence in daily activities, Pre-existing disease — 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

Free text: Asthma flare up. More weak. Need more help with ADLs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-29
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-01-20
Survey response — 12 months, dose 1
MedDRA: Death — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: (b)(6) died on August 14, 2021. This has been reported many times to you. Please CORRECT your files. And your date selection is inaccurate!!!

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Report sent to call center — 12 months, dose 1
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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-21
Call successful
Other

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-02-04	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-02-10	Successful 2021-06-29	Reported to VAERS voluntarily prior to GDIT contact
2022-01-20	Successful 2022-01-21	Other

Free text

Release 3 — day 14, dose 1

2021-02-04

Symptoms: STROKE within 48 hours of receiving vaccine.(b)(6); 1/22-27/2021.Tested COVID antibody positive January 7, 2021.Tested COVID negative at that same time.Received vaccine in Assisted Living Facility on January 20, 2021.

redacted (b)(6)

Release 4 — day 21, dose 1

2021-02-10

Symptoms: Asthma flare up. More weak. Need more help with ADLs

Release 10 — 12 months, dose 1

Reports this person's death

2022-01-20

Symptoms: (b)(6) died on August 14, 2021. This has been reported many times to you. Please CORRECT your files. And your date selection is inaccurate!!!

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
SD	Asthenia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Cerebrovascular accident	✓	✓	✓
SD	Death	·	·	✓
SD	Hospitalisation	○	○	○
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	SARS-CoV-2 antibody test positive	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	SARS-CoV-2 test positive	○	○	○

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