ZRX-16527-22101

1 vaccination 7 coded responses 8 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 080 / NJ
Registered: 2021-04-10

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

2021-03-27
Dose 1 — Pfizer-BioNTech
2021-04-10
Registered in v-safe
2021-04-10
Survey response — day 14, dose 1
MedDRA: Anaphylactic reaction, Emergency care, Immediate post-injection reaction — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Each day since the vaccine was administered I have been having different organs affected by the vaccine. 1st within a couple minutes went into anaphylactic taken by ambulance to ED and was there 7+ hours being treated. Placed on steroids and Benadry.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 14, dose 1
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)
2021-04-17
Survey response — day 21, dose 1
MedDRA: Anaphylactic reaction, Cardiac disorder, Diarrhoea, Hepatic enzyme increased, Hospitalisation, Multi-organ disorder, Muscle spasms, Nausea, Oedema, Positive airway pressure therapy, Rash erythematous, Stridor, Unevaluable event, Visual impairment — 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, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Ive been Hospitalized because of the vaccine. Each 24-36 hours a different organ has problems. Started with anaphylactic breathing, strider, red rash, nausea, diarrhea, liver enzymes high, edema,bipap, cardiac changes, muscle cramps visual changes · Healthcare visit (other): Therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 21, dose 1
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)
2021-04-24
Survey response — day 28, dose 1
MedDRA: Gastrointestinal disorder, Vertigo — 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

Free text: Vertigo, continue to have GI issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — day 28, dose 1
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)
2021-05-01
Survey response — day 35, dose 1
MedDRA: Eye pain, Office visit, Vision blurred, Visual field defect — 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

Free text: Symptoms: Vision extremely blurry continue to have arches on side of eyes. Peripheral vision worsen · Healthcare visit (other): Visual check up being done in May

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Report sent to call center — day 35, dose 1
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)
2021-05-08
Survey response — day 42, dose 1
MedDRA: Vertigo — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Survey response — 3 months, dose 1
MedDRA: Fatigue, Migraine, Pre-existing disease, Vertigo — 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: Fatigue Increase in Vertigo Increase in migraines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Report sent to call center — 3 months, 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 1 — Left Voicemail
2021-06-29
Callback requested for
2021-06-29
Call successful
Completed over the phone
2021-09-25
Health check-in — 6 months, dose 1
Feeling: Fair

Adult check-in
2022-03-28
Survey response — 12 months, dose 1
MedDRA: Amnesia, Brain fog, Fatigue, Feeling abnormal — Feeling: Poor · 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: Extreme fatigue now lasting all the time I never feel good Also have brain fog and memory loss

MedDRA releases: 2024-11 · check-in free text available
2022-03-28
Report sent to call center — 12 months, dose 1
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)
2022-03-29
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-10	Successful	Completed over the phone
2021-04-17	Successful	Completed over the phone
2021-04-24	Successful	Completed over the phone
2021-05-01	Successful	Completed over the phone
2021-06-26	Successful 2021-06-29	Completed over the phone
2022-03-28	Unsuccessful

Free text

Release 7 — day 14, dose 1

2021-04-10

Symptoms: Each day since the vaccine was administered I have been having different organs affected by the vaccine. 1st within a couple minutes went into anaphylactic taken by ambulance to ED and was there 7+ hours being treated. Placed on steroids and Benadry. cut off by CDC

Release 7 — day 21, dose 1

2021-04-17

Symptoms: Ive been Hospitalized because of the vaccine. Each 24-36 hours a different organ has problems. Started with anaphylactic breathing, strider, red rash, nausea, diarrhea, liver enzymes high, edema,bipap, cardiac changes, muscle cramps visual changes

Healthcare visit (other): Therapy

Release 7 — day 28, dose 1

2021-04-24

Symptoms: Vertigo, continue to have GI issues

Release 8 — day 35, dose 1

2021-05-01

Symptoms: Vision extremely blurry continue to have arches on side of eyes. Peripheral vision worsen

Healthcare visit (other): Visual check up being done in May

Release 8 — day 42, dose 1

2021-05-08

Symptoms: Vertigo

Release 9 — 3 months, dose 1

2021-06-26

Symptoms: Fatigue Increase in Vertigo Increase in migraines

Release 11 — 12 months, dose 1

2022-03-28

Symptoms: Extreme fatigue now lasting all the time I never feel good Also have brain fog and memory loss

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	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Amnesia	·	·	✓
SD	Anaphylactic reaction	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Cardiac disorder	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Hepatic enzyme increased	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Immediate post-injection reaction	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Multi-organ disorder	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oedema	✓	✓	✓
SD	Positive airway pressure therapy	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Stridor	✓	✓	✓
SD	Vertigo	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SD	Visual field defect	✓	✓	✓
SD	Visual impairment	✓	✓	✓

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