T9M-88244-34750

3 vaccinations 6 coded responses 30 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 05-11
ZIP prefix: 280 / NC
Registered: 2021-11-23

Relationship: Child or adolescent in my care
Guardian: SRM-16467-63248
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-11-04
Dose 1 — Pfizer-BioNTech
2021-11-23
Registered in v-safe
2021-11-23
Dose 2 — Pfizer-BioNTech
2021-11-23
Health check-in — day 0, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-26
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-11-28
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Productive cough — Feeling: Fair

Free text: Wet cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — day 7, dose 2, dependent
Feeling: Fair · None

Adult check-in
2021-12-07
Survey response — day 14, dose 2, dependent
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Cough/congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-02-22
Survey response — 3 months, dose 2, dependent
MedDRA: COVID-19, Office visit — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Symptoms: COVID 19 · Healthcare visit (other): School health clinic

MedDRA releases: 2024-11 · check-in free text available
2022-02-22
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

1 call case(s)
2022-02-25
Call successful
Does not wish to fill out VAERS report
2022-05-24
Survey response — 6 months, dose 2, dependent
MedDRA: Rash, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Idiopathic rash and sinus infection

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Report sent to call center — 6 months, dose 2, dependent
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-25
Call 1 — Left Voicemail
2022-05-25
Call 1 — Left Voicemail
2022-07-16
Dose 3 — Pfizer-BioNTech
2022-07-16
Health check-in — day 0, dose 3, dependent
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-07-17
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-07-18
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Site: Pain · Fever · None

Adult check-in
2022-07-19
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-07-20
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-07-21
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Abdominal pain

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-07-23
Health check-in — day 7, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-07-30
Health check-in — day 14, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-06
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-13
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-20
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-27
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2022-10-15
Survey response — 3 months, dose 3, dependent
MedDRA: COVID-19, Sinusitis — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: COVID-19, sinus infection

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Report sent to call center — 3 months, dose 3, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-17
Call 2 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2023-01-14
Survey response — 6 months, dose 3, dependent
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-14
Report sent to call center — 6 months, dose 3, dependent
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-04	Pfizer-BioNTech	No
2	2021-11-23	Pfizer-BioNTech	No
3	2022-07-16	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-22	Successful 2022-02-25	Does not wish to fill out VAERS report
2022-05-24	Successful 2023-01-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-15	Successful 2023-01-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-14	Successful 2023-01-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 10 — days 1–6 daily, dose 2, dependent

2021-11-28

Systemic reaction (other): Wet cough

Release 10 — day 14, dose 2, dependent

2021-12-07

Symptoms: Cough/congestion

Release 11 — 3 months, dose 2, dependent

2022-02-22

Symptoms: COVID 19

Healthcare visit (other): School health clinic

Release 11 — 6 months, dose 2, dependent

2022-05-24

Symptoms: Idiopathic rash and sinus infection

Release 12 — 3 months, dose 3, dependent

2022-10-15

Symptoms: COVID-19, sinus infection

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	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Productive cough	·	·	✓

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