DV3-13769-61206

4 vaccinations 7 coded responses 31 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 079 / NJ
Registered: 2021-03-27

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

Registered dependents

CQC-14628-84239 Child or adolescent in my care · Female · 2022-10-01

Timeline

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

2021-03-27
Registered in v-safe
2021-03-27
Dose 1 — Pfizer-BioNTech
2021-03-27
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Throat irritation — Feeling: Good · Site: Redness · Diarrhea

Free text: Bruising at the injection site; scratchy throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Diarrhea

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal distension — Feeling: Good · Abdominal pain

Free text: Bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 7, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-04-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Pfizer-BioNTech
2021-04-17
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, 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 · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Abdominal pain

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Dry skin — Feeling: Good · Joint pains, Abdominal pain · Be unable to do your normal daily activities

Free text: Over the course of the past few days, my skin has dried out completely. Dehydration is definitely a side effect.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Swollen lymph nodes · Healthcare visit (other): Breast ultrasound and mammogram

MedDRA releases: 2024-11 · check-in free text available
2021-07-17
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-26
Call 1 — Left Voicemail
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swollen lymphnodes in left and right armpit near breast tissue · Healthcare visit (other): Mammogram and breast ultrasound

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-20
Call successful
Participant prefers to complete VAERS report online
2021-11-19
Dose 3 — Pfizer-BioNTech
2022-04-19
Survey response — 12 months, dose 2
MedDRA: No adverse event, Pregnancy — Feeling: Good

Free text: No symptoms; 10 weeks pregnant

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-01
Survey response — day 14, dose 4
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Lymph nodes in armpits became swollen

MedDRA releases: 2024-11 · check-in free text available
2022-10-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-18
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Pfizer-BioNTech
2	2021-04-17	Pfizer-BioNTech
3	2021-11-19	Pfizer-BioNTech	No
4	2022-09-17	Pfizer-BioNTech	Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-31

Systemic reaction (other): Bruising at the injection site; scratchy throat.

2021-04-02

Systemic reaction (other): Bloating

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Over the course of the past few days, my skin has dried out completely. Dehydration is definitely a side effect.

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: Swollen lymph nodes

Healthcare visit (other): Breast ultrasound and mammogram

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: Swollen lymphnodes in left and right armpit near breast tissue

Healthcare visit (other): Mammogram and breast ultrasound

Release 11 — 12 months, dose 2

2022-04-19

Symptoms: No symptoms; 10 weeks pregnant

Release 12 — day 14, dose 4

2022-10-01

Symptoms: Lymph nodes in armpits became swollen

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	Unevaluable event	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	No adverse event	·	·	✓
SD	Pregnancy	·	·	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Dehydration	✓	✓	✓
SRO	Dry skin	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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