36Y-10385-32994

3 vaccinations 6 coded responses 27 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 921 / CA
Registered: 2021-02-26

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

CJC-12790-12277 Child or adolescent in my care · Male · 2022-06-22

Timeline

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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Pfizer-BioNTech
2021-02-26
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site vesicles — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Small blister at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Dose 2 — Pfizer-BioNTech
2021-03-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Itching · Muscle or body aches

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — day 14, dose 2
MedDRA: Unevaluable event — Feeling: Fair

Free text: Common cold?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-18
Survey response — 3 months, dose 2
MedDRA: Bronchitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Report sent to call center — 3 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)
2021-06-25
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-18
Dose 3 — Pfizer-BioNTech
2022-02-17
Survey response — 3 months, dose 3
MedDRA: Croup infectious, Laryngitis, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bad seasonal allergies. Croup/laryngitis.

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-18
Call 1 — Left Voicemail
2022-05-20
Survey response — 6 months, dose 3
MedDRA: Croup infectious, Laryngitis, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Croup/laryngitis. Bad seasonal allergies.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Survey response — 12 months, dose 3
MedDRA: Abortion spontaneous, Bronchitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Bronchitis last month. Miscarriage last month.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Pfizer-BioNTech
2	2021-03-19	Pfizer-BioNTech
3	2021-11-18	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-18	Successful 2021-06-25	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-17	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-27

Systemic reaction (other): Small blister at injection site.

Release 6 — day 14, dose 2

2021-04-02

Symptoms: Common cold?

Release 9 — 3 months, dose 2

2021-06-18

Symptoms: Bronchitis

Release 11 — 3 months, dose 3

2022-02-17

Symptoms: Bad seasonal allergies. Croup/laryngitis.

Release 11 — 6 months, dose 3

2022-05-20

Symptoms: Croup/laryngitis. Bad seasonal allergies.

Release 12 — 12 months, dose 3

2022-11-18

Symptoms: Bronchitis last month. Miscarriage last month.

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	Abortion spontaneous	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	Croup infectious	·	·	✓
SD	Laryngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Injection site vesicles	✓	✓	✓

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