KC4-93783-42146

3 vaccinations 10 coded responses 38 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 05-11
ZIP prefix: 946 / CA
Registered: 2022-06-23

Relationship: Child or adolescent in my care
Guardian: 28Q-18656-44165
Race: Black or African American
Ethnicity: Hispanic or Latino

Timeline

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

2022-06-23
Registered in v-safe
2022-07-11
Dose 1 — Pfizer-BioNTech
2022-07-11
Health check-in — day 0, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-12
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-13
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-14
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-15
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-16
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-17
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-18
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-25
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2022-08-01
Dose 2 — Pfizer-BioNTech
2022-08-01
Health check-in — day 0, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-02
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-08-03
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-08-04
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-05
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-06
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-07
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-08
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-15
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-22
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-29
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-09-05
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-09-12
Survey response — day 42, dose 2, dependent
MedDRA: Cough, Headache, Pyrexia, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sniffles, headache, cough, low grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-09-12
Report sent to call center — day 42, dose 2, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-31
Survey response — 3 months, dose 2, dependent
MedDRA: Cough, Pyrexia, Rhinorrhoea, Skin warm, Sneezing — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Constant sniffles and warm body with some low grade fevers. Cough and sneezing is constant as well

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Report sent to call center — 3 months, dose 2, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-01
Call successful
Does not wish to fill out VAERS report
2022-12-14
Dose 3 — Pfizer-BioNTech
2022-12-14
Health check-in — day 0, dose 3, dependent
Feeling: Good · Site: Pain · Fever · None

Adult check-in
2022-12-15
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-12-16
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2022-12-17
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Respiratory tract congestion — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Dysphonia, Respiratory tract congestion — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hoarse voice and congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Cough, Respiratory tract congestion, Sneezing — Feeling: Poor · Fever · Fatigue or tiredness

Free text: Congestion, coughing, sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Respiratory tract congestion — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Health check-in — day 7, dose 3, dependent
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-12-28
Survey response — day 14, dose 3, dependent
MedDRA: Cough, Feeling hot, Nasal congestion — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Moist cough that gets worse at night. Warm forehead no fever. Nasal congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-12-28
Report sent to call center — day 14, dose 3, dependent
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-29
Call 3 — Left Voicemail
2023-01-04
Survey response — day 21, dose 3, dependent
MedDRA: Cough — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-04
Report sent to call center — day 21, dose 3, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-05
Call 1 — Left Voicemail
2023-01-05
Call 1 — Left Voicemail
2023-01-11
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2023-01-18
Health check-in — day 35, dose 3, dependent
Feeling: Fair

Adult check-in
2023-01-25
Survey response — day 42, dose 3, dependent
MedDRA: Cough — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-25
Report sent to call center — day 42, dose 3, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-26
Call 2 — Left Voicemail
2023-01-26
Call 2 — Left Voicemail
2023-01-26
Call 1 — Left Voicemail
2023-03-15
Survey response — 3 months, dose 3, dependent
MedDRA: Attention deficit hyperactivity disorder, Pyrexia, Sputum discoloured — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-15
Report sent to call center — 3 months, dose 3, dependent
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-16
Call successful
Does not wish to fill out VAERS report
2023-03-16
Call successful
Does not wish to fill out VAERS report
2023-03-16
Call successful
Does not wish to fill out VAERS report
2023-03-16
Call successful
Does not wish to fill out VAERS report
2023-06-14
Health check-in — 6 months, dose 3, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-07-11	Pfizer-BioNTech	No
2	2022-08-01	Pfizer-BioNTech	No
3	2022-12-14	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-12	Successful 2022-09-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-31	Successful 2022-11-01	Does not wish to fill out VAERS report
2022-12-28	Successful 2023-03-16	Does not wish to fill out VAERS report
2023-01-04	Successful 2023-03-16	Does not wish to fill out VAERS report
2023-01-25	Successful 2023-03-16	Does not wish to fill out VAERS report
2023-03-15	Successful 2023-03-16	Does not wish to fill out VAERS report

Free text

Release 12 — day 42, dose 2, dependent

2022-09-12

Symptoms: Sniffles, headache, cough, low grade fever

Release 12 — 3 months, dose 2, dependent

2022-10-31

Symptoms: Constant sniffles and warm body with some low grade fevers. Cough and sneezing is constant as well

Release 12 — days 1–6 daily, dose 3, dependent

2022-12-17

Systemic reaction (other): Congestion

2022-12-18

Systemic reaction (other): Hoarse voice and congestion

2022-12-19

Systemic reaction (other): Congestion, coughing, sneezing

2022-12-20

Systemic reaction (other): Congestion

Release 12 — day 14, dose 3, dependent

2022-12-28

Symptoms: Moist cough that gets worse at night. Warm forehead no fever. Nasal congestion.

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	Attention deficit hyperactivity disorder	·	·	✓
SD	Cough	·	·	✓
SD	Feeling hot	·	·	✓
SD	Headache	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Skin warm	·	·	✓
SD	Sneezing	·	·	✓
SD	Sputum discoloured	·	·	✓
SRO	Cough	·	·	✓
SRO	Dysphonia	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Sneezing	·	·	✓

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