3VP-80884-03261

4 vaccinations 12 coded responses 31 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 21-25
ZIP prefix: 602 / IL
Registered: 2021-10-14

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

Timeline

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

2020-12-21
Dose 1 — Pfizer-BioNTech
2021-01-11
Dose 2 — Pfizer-BioNTech
2021-10-14
Registered in v-safe
2021-10-14
Dose 3 — Pfizer-BioNTech
2021-10-14
Survey response — day 0, dose 3
MedDRA: Dyspnoea, Pre-existing disease — Feeling: Good · Site: Pain

Free text: Shortness of breath (but I have asthma)

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Survey response — days 1–6 daily, dose 3
MedDRA: Asthma, Dizziness, Pain of skin, Pre-existing disease, Sensitive skin — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Asthma exacerbation, dizziness, hypersensitive/painful skin

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Survey response — days 1–6 daily, dose 3
MedDRA: Asthma — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Improving asthma symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
Survey response — days 1–6 daily, dose 3
MedDRA: Asthma, Obstructive airways disorder, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Still experiencing airway tightness from asthma exacerbation that started day of booster, now noticing it all the time

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Survey response — days 1–6 daily, dose 3
MedDRA: Asthma, Pre-existing disease — Feeling: Good

Free text: Asthma exacerbation

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Survey response — days 1–6 daily, dose 3
MedDRA: Asthma, Pre-existing disease — Feeling: Fair

Free text: Still experiencing asthma exacerbation

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Survey response — days 1–6 daily, dose 3
MedDRA: Asthma, Medical counselling, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Asthma was bad last night · Healthcare visit (other): Required to get covid test to return to work. Pulmonary nurse practitioner prescribed short course of oral steroids

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-21
Survey response — day 7, dose 3
MedDRA: Asthma, Chest discomfort, Cough, Dyspnoea, SARS-CoV-2 test negative — Feeling: Good

Free text: Still have coughing, chest tightness, and shortness of breath consistent with asthma. Tested negative for covid

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Call 2 — Left Voicemail
2021-10-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-04
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-11
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-16
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-14
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-14
Survey response — 12 months, dose 3
MedDRA: Asthma, COVID-19, Disturbance in attention, Fatigue, Pre-existing disease — Feeling: Fair · 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: I got covid 2x - June and July 2022. The 1st case was mild and I recovered quickly, but the 2nd case I had more symptoms and it triggered my asthma. Since then, I have had extreme fatigue especially after exercise and difficulty focusing

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call successful
Participant prefers to complete VAERS report online
2022-10-17
Call successful
Participant prefers to complete VAERS report online
2022-12-08
Dose 4 — Moderna
2022-12-08
Survey response — day 0, dose 4
MedDRA: Sensitive skin — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Skin sensitivity

MedDRA releases: 2024-11 · check-in free text available
2022-12-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-12-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-12-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-12-15
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-12-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-05
Survey response — day 28, dose 4
MedDRA: Cold sweat, Dizziness, Feeling hot, Headache, Nausea, Presyncope — Feeling: Good

MedDRA releases: 2024-11
2023-01-12
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-19
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-09
Survey response — 3 months, dose 4
MedDRA: Angular cheilitis, Cyanosis, Dizziness, Fatigue, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-09
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-10
Call successful
Does not wish to fill out VAERS report
2023-06-08
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-21	Pfizer-BioNTech	No
2	2021-01-11	Pfizer-BioNTech	No
3	2021-10-14	Pfizer-BioNTech	No
4	2022-12-08	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 10 — day 0, dose 3

2021-10-14

Systemic reaction (other): Shortness of breath (but I have asthma)

Release 10 — days 1–6 daily, dose 3

2021-10-15

Systemic reaction (other): Asthma exacerbation, dizziness, hypersensitive/painful skin

2021-10-16

Systemic reaction (other): Improving asthma symptoms

2021-10-17

Systemic reaction (other): Still experiencing airway tightness from asthma exacerbation that started day of booster, now noticing it all the time

2021-10-18

Systemic reaction (other): Asthma exacerbation

2021-10-19

Systemic reaction (other): Still experiencing asthma exacerbation

2021-10-20

Systemic reaction (other): Asthma was bad last night

Healthcare visit (other): Required to get covid test to return to work. Pulmonary nurse practitioner prescribed short course of oral steroids

Release 10 — day 7, dose 3

2021-10-21

Systemic reaction (other): Still have coughing, chest tightness, and shortness of breath consistent with asthma. Tested negative for covid

Release 12 — 12 months, dose 3

2022-10-14

Symptoms: I got covid 2x - June and July 2022. The 1st case was mild and I recovered quickly, but the 2nd case I had more symptoms and it triggered my asthma. Since then, I have had extreme fatigue especially after exercise and difficulty focusing

Release 12 — day 0, dose 4

2022-12-08

Systemic reaction (other): Skin sensitivity

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	Medical counselling	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Angular cheilitis	·	·	✓
SD	Asthma	·	·	✓
SD	Cold sweat	·	·	✓
SD	COVID-19	·	·	✓
SD	Cyanosis	·	·	✓
SD	Disturbance in attention	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling hot	·	·	✓
SD	Headache	·	·	✓
SD	Nausea	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Presyncope	·	·	✓
SRO	Asthma	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Cough	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Obstructive airways disorder	·	·	✓
SRO	Pain of skin	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	SARS-CoV-2 test negative	·	·	✓
SRO	Sensitive skin	·	·	✓

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