59F-19668-47640

4 vaccinations 6 coded responses 30 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 335 / FL
Registered: 2021-04-21

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Registered dependents

3X8-43730-23761 Child or adolescent in my care · Female · 2022-10-16

Timeline

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

2021-03-30
Dose 1 — Pfizer-BioNTech
2021-04-21
Registered in v-safe
2021-04-21
Dose 2 — Pfizer-BioNTech
2021-04-21
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Chills, Joint pains, Muscle or body aches

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: When arm starts to hurt all symptoms start coming

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-05-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Erythema multiforme, Pre-existing disease — Feeling: Good

Free text: I get (b)(6) on legs from pressure/unknown reasons. (B)(6) has been more intense with most recent outbreak. Possibly a shot symptom

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Dose 3 — Pfizer-BioNTech
2021-12-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-25
Survey response — 3 months, dose 3
MedDRA: COVID-19, Medical counselling — 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

Free text: Symptoms: Had COVID · Healthcare visit (other): Spoke to primary Dr office staff

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Report sent to call center — 3 months, dose 3
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)
2022-03-05
Call 1 — Could Not Reach Participant
2022-03-10
Call successful
Does not wish to fill out VAERS report
2022-05-27
Survey response — 6 months, dose 3
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Congestion daily

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-18
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-25
Survey response — day 14, dose 4
MedDRA: Headache — Feeling: Good

Free text: Headaches

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-11
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Pfizer-BioNTech
2	2021-04-21	Pfizer-BioNTech
3	2021-11-26	Pfizer-BioNTech	No
4	2022-10-11	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-02-25	Successful 2022-03-10	Does not wish to fill out VAERS report

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): When arm starts to hurt all symptoms start coming

Release 8 — day 28, dose 2

2021-05-19

Symptoms: I get (b)(6) on legs from pressure/unknown reasons. (B)(6) has been more intense with most recent outbreak. Possibly a shot symptom

redacted (b)(6)

Release 11 — 3 months, dose 3

2022-02-25

Symptoms: Had COVID

Healthcare visit (other): Spoke to primary Dr office staff

Release 11 — 6 months, dose 3

2022-05-27

Symptoms: Congestion daily

Release 12 — day 14, dose 4

2022-10-25

Symptoms: Headaches

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	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Erythema multiforme	✓	✓	✓
SD	Headache	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Pain in extremity	✓	✓	✓

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