43R-11677-04025

4 vaccinations 16 coded responses 37 check-ins 16 free-text entries 10 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 926 / CA
Registered: 2020-12-19

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

2020-12-19
Registered in v-safe
2020-12-19
Dose 1 — Pfizer-BioNTech
2020-12-19
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-22
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: Very tired last night, unsure if related, ok now to

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2020-12-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-13
Dose 2 — Pfizer-BioNTech
2021-01-14
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · 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
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Poor · Headache · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-10
Survey response — day 28, dose 2
MedDRA: Asthma, Chest pain, SARS-CoV-2 test — Feeling: Good · 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: Symptoms: Chest pain and asthma · Healthcare visit (other): Covid test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Survey response — day 35, dose 2
MedDRA: Arthralgia, Asthma, Chest pain, Condition aggravated, Pre-existing disease — Feeling: Fair · 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: Chest pain and asthma exacerbation, worsening joint pain, autoimmune issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
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)
2021-02-24
Survey response — day 42, dose 2
MedDRA: Asthma, Gastrooesophageal reflux disease, Pre-existing disease — Feeling: Fair · 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: Worsening asthma and GERD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-14
Survey response — 3 months, dose 2
MedDRA: Anaemia, Asthma, Gastrooesophageal reflux disease, Psoriatic arthropathy — Feeling: Poor · Be unable to work, 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: Diagnosed with psoriatic arthritis and anemia, also GERD and worsening asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Call 1 — Could Not Reach Participant
2021-06-15
Call 2 — Left Voicemail
2021-07-16
Survey response — 6 months, dose 2
MedDRA: Glucose tolerance impaired, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Diagnosed with pre-diabetes and have a lot of autoimmune issues

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-16
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Call 1 — Left Voicemail
2021-12-10
Call successful
Participant prefers to complete VAERS report online
2021-12-27
Dose 3 — Moderna
2022-01-13
Survey response — 12 months, dose 2
MedDRA: Accident, Glucose tolerance impaired, Headache, Intervertebral disc protrusion, Leptin receptor deficiency, Pain, Weight gain poor — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Lepton deficiency along with pre-diabetes, inability to gain weight Unrelated- bulging discs neck from accident- h/a and pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-14
Call 1 — Left Voicemail
2022-11-08
Dose 4 — Moderna
2022-11-08
Survey response — day 0, dose 4
MedDRA: Chest discomfort — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Some chest discomfort

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-11-12
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-17
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-22
Survey response — day 14, dose 4
MedDRA: Nasopharyngitis — Feeling: Good

Free text: Just cold like symptoms which I think are unrelated

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Survey response — day 21, dose 4
MedDRA: COVID-19, Cough, Exposure to SARS-CoV-2, Headache, Musculoskeletal stiffness, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, cough, runny nose, congestion, headache and stiff neck, was exposed to Covid, test still negative after 2 days, but pretty sure I have it

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Survey response — day 28, dose 4
MedDRA: Malaise — 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 · Outpatient clinic or urgent care clinic visit

Free text: Just Covid symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Report sent to call center — day 28, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-07
Call 2 — Left Voicemail
2022-12-07
Call 1 — Left Voicemail
2022-12-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-14
Survey response — day 35, dose 4
MedDRA: COVID-19, Ear pain, Oropharyngeal pain, Viral infection — Feeling: Good · Be unable to do your normal daily activities

Free text: Just another virus after Covid- sore throat and ear pain

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-07
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-19	Pfizer-BioNTech
2	2021-01-13	Pfizer-BioNTech
3	2021-12-27	Moderna	No
4	2022-11-08	Moderna	No

Call center

10 call center cases

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

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-22

Systemic reaction (other): Very tired last night, unsure if related, ok now to

Release 2 — days 1–6 daily, dose 2

2021-01-14

Systemic reaction (other): Sore throat

2021-01-16

Systemic reaction (other): Sore throat

Release 3 — day 28, dose 2

2021-02-10

Symptoms: Chest pain and asthma

Healthcare visit (other): Covid test

Release 4 — day 35, dose 2

2021-02-18

Symptoms: Chest pain and asthma exacerbation, worsening joint pain, autoimmune issues

Release 4 — day 42, dose 2

2021-02-24

Symptoms: Worsening asthma and GERD

Release 7 — 3 months, dose 2

2021-04-14

Symptoms: Diagnosed with psoriatic arthritis and anemia, also GERD and worsening asthma

Release 9 — 6 months, dose 2

2021-07-16

Symptoms: Diagnosed with pre-diabetes and have a lot of autoimmune issues

Release 10 — 12 months, dose 2

2022-01-13

Symptoms: Lepton deficiency along with pre-diabetes, inability to gain weight Unrelated- bulging discs neck from accident- h/a and pain

Release 12 — day 0, dose 4

2022-11-08

Systemic reaction (other): Some chest discomfort

Release 12 — days 1–6 daily, dose 4

2022-11-09

Systemic reaction (other): Congestion

2022-11-12

Systemic reaction (other): Sore throat

Release 12 — day 14, dose 4

2022-11-22

Symptoms: Just cold like symptoms which I think are unrelated

Release 12 — day 21, dose 4

2022-11-29

Symptoms: Sore throat, cough, runny nose, congestion, headache and stiff neck, was exposed to Covid, test still negative after 2 days, but pretty sure I have it

Release 12 — day 28, dose 4

2022-12-06

Symptoms: Just Covid symptoms

Release 12 — day 35, dose 4

2022-12-14

Symptoms: Just another virus after Covid- sore throat and ear pain

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	SARS-CoV-2 test	✓	✓	✓
SD	Accident	·	·	✓
SD	Anaemia	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Autoimmune disorder	○	○	○
SD	Chest pain	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Ear pain	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Glucose tolerance impaired	✓	·	✓
SD	Headache	·	·	✓
SD	Intervertebral disc protrusion	·	·	✓
SD	Leptin receptor deficiency	·	·	✓
SD	Malaise	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Psoriatic arthropathy	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Viral infection	·	·	✓
SD	Weight gain poor	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓

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