4QM-12802-88885

4 vaccinations 7 coded responses 31 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 945 / CA
Registered: 2021-09-28

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

2021-01-26
Dose 1 — Pfizer-BioNTech
2021-02-18
Dose 2 — Pfizer-BioNTech
2021-09-28
Registered in v-safe
2021-09-28
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-09-28
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-09-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-09-30
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Insomnia, Terminal insomnia — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Dry cough last night and early morning awakening/insomnia. I dont know if these are related to the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-03-29
Survey response — 6 months, dose 3
MedDRA: Gastroenteritis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Gastroenteritis

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-30
Call 1 — Left Voicemail
2022-05-21
Dose 4 — Moderna
2022-05-21
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-05-22
Survey response — days 1–6 daily, dose 4
MedDRA: Chills — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Chills last night for about an hour

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Free text: I'm wondering if these are all side effects or whether I might also have the flu. I did take my temp and it was not elevated, but I don't trust the (cheap) thermometer.

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Survey response — days 1–6 daily, dose 4
MedDRA: Feeling abnormal, Nausea — Feeling: Fair · Fatigue or tiredness

Free text: Slightly "off"/ queasy feeling

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-28
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-11
Survey response — day 21, dose 4
MedDRA: Gastritis — 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

Free text: Acute gastritis

MedDRA releases: 2024-11 · check-in free text available
2022-06-11
Report sent to call center — day 21, 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 · 1 call case(s)
2022-06-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-19
Survey response — day 28, dose 4
MedDRA: Allergic respiratory symptom, Chills, Cough, Food poisoning, Gastritis, Headache, Nausea — 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 · Telehealth, virtual health, or email health consultation

Free text: Not related to covid: food poisoning, gastritis, allergy symptoms (headache, dry cough), nausea, chills

MedDRA releases: 2024-11 · check-in free text available
2022-06-19
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-21
Call 2 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-19
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-21
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Pfizer-BioNTech	No
2	2021-02-18	Pfizer-BioNTech	No
3	2021-09-28	Pfizer-BioNTech	Flu
4	2022-05-21	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 3

2021-09-30

Systemic reaction (other): Dry cough last night and early morning awakening/insomnia. I dont know if these are related to the vaccine.

Release 11 — 6 months, dose 3

2022-03-29

Symptoms: Gastroenteritis

Release 11 — days 1–6 daily, dose 4

2022-05-22

Systemic reaction (other): Chills last night for about an hour

2022-05-23

Systemic reaction (other): I'm wondering if these are all side effects or whether I might also have the flu. I did take my temp and it was not elevated, but I don't trust the (cheap) thermometer.

2022-05-24

Systemic reaction (other): Slightly "off"/ queasy feeling

Release 12 — day 21, dose 4

2022-06-11

Symptoms: Acute gastritis

Release 12 — day 28, dose 4

2022-06-19

Symptoms: Not related to covid: food poisoning, gastritis, allergy symptoms (headache, dry cough), nausea, chills

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	Allergic respiratory symptom	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Food poisoning	·	·	✓
SD	Gastritis	·	·	✓
SD	Gastroenteritis	·	·	✓
SD	Headache	·	·	✓
SD	Nausea	·	·	✓
SRO	Chills	·	·	✓
SRO	Cough	·	·	✓
SRO	Feeling abnormal	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Nausea	·	·	✓
SRO	Terminal insomnia	·	·	✓
SRO	Unevaluable event	·	·	✓

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