4SG-30807-61685

4 vaccinations 5 coded responses 25 check-ins 4 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 933 / CA
Registered: 2021-04-21

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

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1696062 (opens in a new window)	high	10 / 11	—	1 of 4 VAERS symptoms	same dose (2)	CA matches	2021-05-12 / 2021-05-30 / 2021-09-14 received the same day as the last call	case 928607

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

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

2021-03-19
Dose 1 — Pfizer-BioNTech
2021-04-21
Registered in v-safe
2021-04-21
Survey response — day 28, dose 1
MedDRA: Chills, Cough, Headache, Immunisation reaction, Office visit, Pneumonia, Pyrexia — 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, Emergency room or emergency department visit

Free text: 3 days after the 1st vaccination, I started to get headache, 102 fever. Coughing started. At Urgent Care on 3/23 diagnostic was vaccination side effects. Continue to have fever, cough, chills, and headache for two weeks turned into pneumonia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 28, dose 1
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)
2021-04-23
Health check-in — day 35, dose 1
Feeling: Poor

Adult check-in
2021-04-30
Survey response — day 42, dose 1
MedDRA: Illness, Immune system disorder, Pneumonia — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Side effects from the vaccine developed pneumonia and lower immune system developed another illness making me unable to receive second shot!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 42, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Dose 2 — Pfizer-BioNTech
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-09
Survey response — day 28, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: Pains in calf

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-11
Survey response — 3 months, dose 2
MedDRA: Headache, Office visit — 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

Free text: Symptoms: Sever headache · Healthcare visit (other): Family doctor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-11
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-17
Call 1 — Left Voicemail
2021-09-13
Call 2 — Requested Callback
2021-09-14
Callback requested for
04:00PM ET
2021-09-14
Call successful
Completed over the phone
2021-11-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Pfizer-BioNTech
2022-09-09
Dose 4 — Pfizer-BioNTech
2022-09-09
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-09-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-16
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-25
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-09-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-10
Survey response — 6 months, dose 4
MedDRA: COVID-19, Cough, Total lung capacity decreased — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-10
Report sent to call center — 6 months, 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)
2023-03-13
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Pfizer-BioNTech
2	2021-05-12	Pfizer-BioNTech
3	2021-12-10	Pfizer-BioNTech	No
4	2022-09-09	Pfizer-BioNTech	No

Call center

4 call center cases

4 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 7 — day 28, dose 1

2021-04-21

Symptoms: 3 days after the 1st vaccination, I started to get headache, 102 fever. Coughing started. At Urgent Care on 3/23 diagnostic was vaccination side effects. Continue to have fever, cough, chills, and headache for two weeks turned into pneumonia.

Release 8 — day 42, dose 1

2021-04-30

Symptoms: Side effects from the vaccine developed pneumonia and lower immune system developed another illness making me unable to receive second shot!

Release 9 — day 28, dose 2

2021-06-09

Symptoms: Pains in calf

Release 9 — 3 months, dose 2

2021-08-11

Symptoms: Sever headache

Healthcare visit (other): Family doctor

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	✓	·	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Headache	✓	✓	✓
SD	Illness	✓	✓	✓
SD	Immune system disorder	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Total lung capacity decreased	·	·	✓

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