2QH-14771-51386

4 vaccinations 7 coded responses 29 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 021 / MA
Registered: 2021-04-23

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

2021-04-01
Dose 1 — Pfizer-BioNTech
2021-04-22
Dose 2 — Pfizer-BioNTech
2021-04-23
Registered in v-safe
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Loss of consciousness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Lightheadedness, starting to black out

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, Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Hypotension, Office visit — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): low blood pressure (I have HBP normally, which I am treated for) · Healthcare visit (other): Visit with NP at my primary care drs practice

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — day 42, dose 2
MedDRA: Dry throat, Nasopharyngitis, Rhinorrhoea — Feeling: Fair

Free text: Could just be a head cold dry throat , runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Dose 3 — Moderna
2022-04-11
Call 1 — Left Voicemail
2022-04-23
Survey response — 12 months, dose 2
MedDRA: Chills, Cough, Exposure to SARS-CoV-2, Fatigue, Oropharyngeal pain, Pain, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Scorching sore throat, hacking cough, chills, aches, fatigue symptoms mid feb to March, had been w/sister for weekend & she tested positive w/same symptoms, but tested NAAT 10 times and PCR once, and all *negative* for covid

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Dose 4 — Moderna
2022-04-29
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Chills

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-07
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-21
Survey response — day 21, dose 4
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair

Free text: Sore throat, cough, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-29
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · 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

Free text: Covid positive 30 June, rebound case mid July, still recovering

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Report sent to call center — 3 months, dose 4
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 · 1 call case(s)
2022-08-01
Call 2 — Left Voicemail
2022-08-01
Call 1 — Left Voicemail
2022-08-03
Call successful
Participant prefers to complete VAERS report online
2022-08-03
Call successful
Participant prefers to complete VAERS report online
2022-10-30
Survey response — 6 months, dose 4
MedDRA: Chills, Cough, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Very bad sore throat, chills, cough

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Pfizer-BioNTech
2	2021-04-22	Pfizer-BioNTech
3	2021-11-26	Moderna	No
4	2022-04-29	Moderna	No

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Lightheadedness, starting to black out

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): low blood pressure (I have HBP normally, which I am treated for)

Healthcare visit (other): Visit with NP at my primary care drs practice

Release 8 — day 42, dose 2

2021-06-03

Symptoms: Could just be a head cold dry throat , runny nose

Release 11 — 12 months, dose 2

2022-04-23

Symptoms: Scorching sore throat, hacking cough, chills, aches, fatigue symptoms mid feb to March, had been w/sister for weekend & she tested positive w/same symptoms, but tested NAAT 10 times and PCR once, and all *negative* for covid

Release 11 — day 21, dose 4

2022-05-21

Symptoms: Sore throat, cough, runny nose

Release 12 — 3 months, dose 4

2022-07-29

Symptoms: Covid positive 30 June, rebound case mid July, still recovering

Release 12 — 6 months, dose 4

2022-10-30

Symptoms: Very bad sore throat, chills, cough

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	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dry throat	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypotension	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓

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