C7N-19954-06633

4 vaccinations 5 coded responses 30 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 12-15
ZIP prefix: 521 / IA
Registered: 2022-02-05

Relationship: Child or adolescent in my care
Guardian: YYV-15360-43992
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-05-29
Dose 1 — Pfizer-BioNTech
2021-06-19
Dose 2 — Pfizer-BioNTech
2022-02-05
Registered in v-safe
2022-02-05
Dose 3 — Pfizer-BioNTech
2022-02-05
Health check-in — day 0, dose 3, dependent
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-02-06
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-07
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-02-08
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-02-09
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-02-10
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-02-11
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Fever · Chills, Fatigue or tiredness

Adult check-in
2022-02-12
Health check-in — day 7, dose 3, dependent
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-02-19
Health check-in — day 14, dose 3, dependent
Feeling: Fair

Adult check-in
2022-02-26
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-03-05
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-03-12
Survey response — day 35, dose 3, dependent
MedDRA: Headache, Pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school

Free text: Low grade fever, headache, congestion, body aches

MedDRA releases: 2024-11 · check-in free text available
2022-03-19
Survey response — day 42, dose 3, dependent
MedDRA: Pyrexia — Feeling: Good · Be unable to work or attend school

Free text: Low grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Health check-in — 3 months, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-06
Health check-in — 6 months, dose 3, dependent
Feeling: Good

Adult check-in
2022-10-14
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-14
Health check-in — day 0, dose 4, dependent
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-15
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-10-18
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-10-19
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-10-20
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-21
Survey response — day 7, dose 4, dependent
MedDRA: Chest discomfort, Cough — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Chest tightness, cough

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Health check-in — day 14, dose 4, dependent
Feeling: Fair

Adult check-in
2022-11-07
Health check-in — day 21, dose 4, dependent
Feeling: Fair

Adult check-in
2022-11-13
Health check-in — day 28, dose 4, dependent
Feeling: Good

Adult check-in
2022-11-20
Health check-in — day 35, dose 4, dependent
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 42, dose 4, dependent
Feeling: Good

Adult check-in
2023-01-13
Survey response — 3 months, dose 4, dependent
MedDRA: Fatigue, Pyrexia, Syncope — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-14
Survey response — 6 months, dose 4, dependent
MedDRA: COVID-19, Respiratory disorder — 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
2023-04-14
Report sent to call center — 6 months, dose 4, dependent
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)
2023-04-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-29	Pfizer-BioNTech	No
2	2021-06-19	Pfizer-BioNTech	No
3	2022-02-05	Pfizer-BioNTech	No
4	2022-10-14	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2023-04-14	Unsuccessful

Free text

Release 11 — day 35, dose 3, dependent

2022-03-12

Symptoms: Low grade fever, headache, congestion, body aches

Release 11 — day 42, dose 3, dependent

2022-03-19

Symptoms: Low grade fever

Release 12 — day 7, dose 4, dependent

2022-10-21

Systemic reaction (other): Chest tightness, cough

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	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Syncope	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Cough	·	·	✓

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