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XH6-25391-96921

3 vaccinations 4 coded responses 19 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
41-45
ZIP prefix
941 / CA
Registered
2021-04-03
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-20
    Dose 1 — Pfizer-BioNTech
  2. 2021-02-16
    Dose 2 — Pfizer-BioNTech
  3. 2021-04-03
    Registered in v-safe
  4. 2021-04-03
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  5. 2021-05-18
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  6. 2021-08-17
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-09-29
    Dose 3 — Pfizer-BioNTech
  8. 2021-09-29
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  9. 2021-09-30
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site reaction, Rash papular — Feeling: Good · Site: Pain, Redness, Swelling
    Free text: Raised bump at injection site
    MedDRA releases: 2024-11 · check-in free text available
  10. 2021-10-01
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site mass — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches, Fatigue or tiredness
    Free text: Two lumps at and adjacent to injection site
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-10-02
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site mass — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness
    Free text: One bump still at injection site
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-10-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  13. 2021-10-04
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Swelling · None
    Adult check-in
  14. 2021-10-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  15. 2021-10-06
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  16. 2021-10-13
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  17. 2021-10-20
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  18. 2021-10-27
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  19. 2021-11-03
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  20. 2021-11-10
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  21. 2021-12-30
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  22. 2022-03-30
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  23. 2022-09-29
    Survey response — 12 months, dose 3
    MedDRA: Chills, Dyspnoea, Malaise, Myalgia, Pregnancy, SARS-CoV-2 test negative — 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, Outpatient clinic or urgent care clinic visit
    Free text: 2 weeks ago had COVID-like symptoms - shortness of breath, extreme muscle aches and chills. Subsequently had 4 negative home tests, and 1 negative PCR test. I am also 21 weeks pregnant.
    MedDRA releases: 2024-11 · check-in free text available
  24. 2022-09-29
    Report sent to call center — 12 months, dose 3
    Be unable to work or attend school · 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)
  25. 2022-09-30
  26. 2022-09-30
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-01-20Pfizer-BioNTech
22021-02-16Pfizer-BioNTech
32021-09-29Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2022-09-29 Successful
2022-09-30
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 9 — days 1–6 daily, dose 3

2021-09-30

Systemic reaction (other): Raised bump at injection site

2021-10-01

Systemic reaction (other): Two lumps at and adjacent to injection site

2021-10-02

Systemic reaction (other): One bump still at injection site

Release 12 — 12 months, dose 3

2022-09-29

Symptoms: 2 weeks ago had COVID-like symptoms - shortness of breath, extreme muscle aches and chills. Subsequently had 4 negative home tests, and 1 negative PCR test. I am also 21 weeks pregnant.

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

FieldPreferred term2021-092023-042024-11
SDChills · · ✓
SDDyspnoea · · ✓
SDMalaise · · ✓
SDMyalgia · · ✓
SDPregnancy · · ✓
SDSARS-CoV-2 test negative · · ✓
SROInjection site mass · · ✓
SROInjection site reaction · · ✓
SRORash papular · · ✓

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

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