346-29785-77033

4 vaccinations 6 coded responses 37 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 770 / TX
Registered: 2021-03-11

Relationship: Self
Race: White
Ethnicity: N/A

Registered dependents

5MX-49000-21217 Child or adolescent in my care · Female · 2021-11-08

Timeline

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Pfizer-BioNTech
2021-03-11
Survey response — day 0, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Dose 2 — Pfizer-BioNTech
2021-04-03
Survey response — day 0, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Pfizer-BioNTech
2021-11-19
Survey response — day 0, dose 3
MedDRA: Brain fog — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-02-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-05
Dose 4 — Pfizer-BioNTech
2022-11-19
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-11-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-12
Survey response — day 35, dose 4
MedDRA: Cough, Pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school

Free text: Body aches , fever,cough , congestion

MedDRA releases: 2024-11 · check-in free text available
2023-02-04
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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-02-04
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-06
Call 1 — Left Voicemail
2023-05-08
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Pfizer-BioNTech
2	2021-04-03	Pfizer-BioNTech
3	2021-11-19	Pfizer-BioNTech	No
4	2022-11-05	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2023-02-04	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-11

Systemic reaction (other): Brain fog

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): Dizziness

Release 6 — day 0, dose 2

2021-04-03

Systemic reaction (other): Shortness of breath

Release 10 — day 0, dose 3

2021-11-19

Systemic reaction (other): Brain fog

Release 12 — day 35, dose 4

2022-12-12

Symptoms: Body aches , fever,cough , congestion

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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