3QQ-43573-90814

3 vaccinations 8 coded responses 24 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 088 / NJ
Registered: 2020-12-22

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

2020-12-22
Registered in v-safe
2020-12-22
Dose 1 — Pfizer-BioNTech
2020-12-22
Survey response — day 0, dose 1
MedDRA: Office visit, Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Mild Asthma- due to Daily maintenance medications · Healthcare visit (other): Office visit with allergy/ asthma specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-22
Report sent to call center — day 0, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2020-12-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache

Adult check-in
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Call 3 — Left Voicemail
2021-01-04
Call 1 — Left Voicemail
2021-01-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-07
Call 2 — Left Voicemail
2021-01-07
Call successful
Does not wish to fill out VAERS report
2021-01-12
Dose 2 — Pfizer-BioNTech
2021-01-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Headache

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site warmth — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Arm feels hot to the touch around the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Survey response — day 7, dose 2
MedDRA: Dyspnoea, Nasal congestion — Feeling: Good

Free text: Nasal congestion, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 14, dose 2
MedDRA: Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

Free text: For the day after my last check-in I experienced a worsening shortness of breath that has since dissipated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-16
Survey response — day 35, dose 2
MedDRA: Dyspnoea, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breath · Healthcare visit (other): Physician- regular office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-13
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-08-06
Call successful
Participant prefers to complete VAERS report online
2021-10-27
Dose 3 — Pfizer-BioNTech
2022-01-14
Survey response — 12 months, dose 2
MedDRA: Diarrhoea, Ear pain, Fatigue, Headache, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache, feverish, ear ache, sore throat, fatigue, sneezing, diarrhea. I am waiting for results from a cv-19 test

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Survey response — 3 months, dose 3
MedDRA: COVID-19, Diarrhoea, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea - probably because I'm still recovering from cv-19 infection. I tested positive on 1/10/22

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-22	Pfizer-BioNTech
2	2021-01-12	Pfizer-BioNTech
3	2021-10-27	Pfizer-BioNTech	No

Call center

5 call center cases

2 successful · 3 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-22

Systemic reaction (other): Mild Asthma- due to Daily maintenance medications

Healthcare visit (other): Office visit with allergy/ asthma specialist

Release 1 — days 1–6 daily, dose 2

2021-01-13

Systemic reaction (other): Arm feels hot to the touch around the injection site

Release 2 — days 1–6 daily, dose 2

2021-01-18

Systemic reaction (other): Shortness of breath

Release 2 — day 7, dose 2

2021-01-19

Systemic reaction (other): Nasal congestion, shortness of breath

Release 2 — day 14, dose 2

2021-01-26

Symptoms: For the day after my last check-in I experienced a worsening shortness of breath that has since dissipated.

Release 4 — day 35, dose 2

2021-02-16

Symptoms: Shortness of breath

Healthcare visit (other): Physician- regular office visit

Release 10 — 12 months, dose 2

2022-01-14

Symptoms: Headache, feverish, ear ache, sore throat, fatigue, sneezing, diarrhea. I am waiting for results from a cv-19 test

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: Diarrhea - probably because I'm still recovering from cv-19 infection. I tested positive on 1/10/22

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	Specialist consultation	○	○	○
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sneezing	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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