4R9-22426-35927

3 vaccinations 9 coded responses 25 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 629 / IL
Registered: 2021-06-12

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

Registered dependents

5HM-10710-66544 Child or adolescent in my care · Female · 2021-06-12

D2L-46998-08452 Child or adolescent in my care · Female · 2021-06-12

SCG-25535-31131 Adult relative or friend · Male · 2021-06-12

MG9-25867-39286 Child or adolescent in my care · Female · 2022-01-15

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-06-11
Dose 1 — Pfizer-BioNTech
2021-06-12
Registered in v-safe
2021-06-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-06-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-18
Survey response — day 7, dose 1
MedDRA: Chest pain — Feeling: Fair

Free text: Ive had some chest pains yesterday & today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-15
Dose 2 — Pfizer-BioNTech
2021-07-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-07-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-07-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-07-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-07-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-22
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-07-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-08-17
Survey response — day 28, dose 2
MedDRA: Cough, Fatigue, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Mild evening cough. Some congestion, tired.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-26
Survey response — day 42, dose 2
MedDRA: Dysphonia, Respiratory tract congestion — Feeling: Good

Free text: Alot of congestion, changes in my voice starting about 2 weeks after my second dose. Nothing painful or troublesome but it is happening.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-01-11
Dose 3 — Pfizer-BioNTech
2022-01-13
Survey response — 6 months, dose 2
MedDRA: Pain, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Major congestion. Body aches. Took 2 rapid tests. Both negative so I went to get boosted. Now idk if my symptons are the booster or Omicron.

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-16
Survey response — days 1–6 daily, dose 3
MedDRA: Cough — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: coughing

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Survey response — day 7, dose 3
MedDRA: Respiratory tract congestion — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Severe congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — day 14, dose 3
MedDRA: Fatigue, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: extreme fatigue, extreme congestion, still negative for covid

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Survey response — day 35, dose 3
MedDRA: Fatigue, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activities

Free text: Just extreme fatigue & problems completing simple tasks. Not sure whats going on & it may be stress related.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-11	Pfizer-BioNTech
2	2021-07-15	Pfizer-BioNTech	No
3	2022-01-11	Pfizer-BioNTech	No

Free text

Release 9 — day 7, dose 1

2021-06-18

Systemic reaction (other): Ive had some chest pains yesterday & today.

Release 9 — day 28, dose 2

2021-08-17

Symptoms: Mild evening cough. Some congestion, tired.

Release 9 — day 42, dose 2

2021-08-26

Symptoms: Alot of congestion, changes in my voice starting about 2 weeks after my second dose. Nothing painful or troublesome but it is happening.

Release 10 — 6 months, dose 2

2022-01-13

Symptoms: Major congestion. Body aches. Took 2 rapid tests. Both negative so I went to get boosted. Now idk if my symptons are the booster or Omicron.

Release 10 — days 1–6 daily, dose 3

2022-01-16

Systemic reaction (other): coughing

2022-01-17

Systemic reaction (other): congestion

Release 10 — day 7, dose 3

2022-01-20

Systemic reaction (other): Severe congestion

Release 11 — day 14, dose 3

2022-01-25

Symptoms: extreme fatigue, extreme congestion, still negative for covid

Release 11 — day 35, dose 3

2022-02-18

Symptoms: Just extreme fatigue & problems completing simple tasks. Not sure whats going on & it may be stress related.

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	Cough	✓	·	✓
SD	Dysphonia	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Pain	·	·	✓
SD	Respiratory tract congestion	✓	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Respiratory tract congestion	·	·	✓

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