64L-11225-94852

3 vaccinations 7 coded responses 29 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 317 / GA
Registered: 2021-03-20

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

Registered dependents

NS6-27240-74197 Child or adolescent in my care · Male · 2021-10-16

U2P-80329-78306 Child or adolescent in my care · Female · 2021-10-16

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Pfizer-BioNTech
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Multiple allergies, Throat irritation — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Scratchy throat and allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 7, dose 1
MedDRA: Hypersensitivity, Nasal congestion — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy. nose; allergiea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 21, dose 1
MedDRA: Office visit, Oral surgery, Wisdom teeth removal — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Wisdom tooth surgery on Thursday · Healthcare visit (other): Surgery at oral surgery office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 21, 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)
2021-04-13
Dose 2 — Pfizer-BioNTech
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Dose 3 — Pfizer-BioNTech
2021-10-16
Survey response — day 0, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Be unable to work or attend school

Free text: Sore throat before shot

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-19
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Good

Free text: Seasonal allergies

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-15
Survey response — 3 months, dose 3
MedDRA: Ageusia, Anosmia, Chest pain, Chills, Cough, Dyspnoea, Fatigue, Malaise, Night sweats, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Chills, night sweats, fever, body aches, loss of taste/smell, malaise, extreme fatigue, chest pain, shortness of breath, cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-18
Call 1 — Left Voicemail
2022-04-16
Survey response — 6 months, dose 3
MedDRA: COVID-19 — 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 · Hospitalization

Free text: COVID-19

MedDRA releases: 2024-11 · check-in free text available
2022-04-16
Report sent to call center — 6 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

Hospitalization · 1 call case(s)
2022-04-20
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Pfizer-BioNTech
2	2021-04-13	Pfizer-BioNTech
3	2021-10-16	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-10	Unsuccessful
2022-01-15	Unsuccessful
2022-04-16	Successful 2022-04-20	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-26

Systemic reaction (other): Scratchy throat and allergies

Release 6 — day 7, dose 1

2021-03-27

Systemic reaction (other): Stuffy. nose; allergiea

Release 7 — day 21, dose 1

2021-04-10

Symptoms: Wisdom tooth surgery on Thursday

Healthcare visit (other): Surgery at oral surgery office

Release 10 — day 0, dose 3

2021-10-16

Systemic reaction (other): Sore throat before shot

Release 10 — days 1–6 daily, dose 3

2021-10-19

Systemic reaction (other): Seasonal allergies

Release 10 — 3 months, dose 3

2022-01-15

Symptoms: Chills, night sweats, fever, body aches, loss of taste/smell, malaise, extreme fatigue, chest pain, shortness of breath, cough

Release 11 — 6 months, dose 3

2022-04-16

Symptoms: COVID-19

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	✓	✓	✓
HCVO	Oral surgery	✓	✓	✓
SD	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	·	·	✓
SD	Night sweats	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Wisdom teeth removal	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Multiple allergies	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Throat irritation	✓	✓	✓

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