XUQ-24056-15837

3 vaccinations 6 coded responses 29 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 640 / MO
Registered: 2021-03-06

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Registered dependents

SHJ-41757-26780 Child or adolescent in my care · Female · 2022-02-06

BWP-12117-11990 Child or adolescent in my care · Female · 2022-02-06

LSJ-27533-35249 Child or adolescent in my care · Male · 2022-02-06

Timeline

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

2021-03-06
Registered in v-safe
2021-03-06
Dose 1 — Pfizer-BioNTech
2021-03-06
Survey response — 0 day, dose 1
MedDRA: Ocular discomfort — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — 7 day, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-20
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-03-26
Dose 2 — Pfizer-BioNTech
2021-03-26
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-03
Health check-in — 7 day, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-09
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-26
Survey response — 6 month, dose 2
MedDRA: Bone pain, Fatigue — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-01-09
Dose 3 — Pfizer-BioNTech
2022-02-06
Survey response — 28 day, dose 3
MedDRA: Cough, Fatigue, Headache, Influenza, Pyrexia, SARS-CoV-2 test negative, Sinus pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-02-13
Survey response — 35 day, dose 3
MedDRA: Asthma, Cough, Dizziness, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-02-13
Report sent to call center — 35 day, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-02-22
Survey response — 42 day, dose 3
MedDRA: Chills, Cough, Dyspnoea, Headache, Pyrexia, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-02-25
Call 1 — Left Voicemail
2022-04-10
Survey response — 3 month, dose 3
MedDRA: Asthma, COVID-19, Cough, Dyspnoea, Pre-existing disease, Secretion discharge, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-07-10
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Pfizer-BioNTech
2	2021-03-26	Pfizer-BioNTech
3	2022-01-09	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-13	Unsuccessful

Free text

Release 5

Systemic reaction (other): Eye pressure

Release 9

Symptoms: Aches to the bone. Fatigue

Release 11

Symptoms: Bad flu-cough, sinus pain fatigue, headache, low grade fever. Tested negative twice for covid-19 since flu symptoms began.

Symptoms: Worse cough. Worse asthma. Lightheadedness

Healthcare visit (other): Family

Symptoms: Cough, low fever, headache, chills, some sneezing, frequent inhaler use for shortness breath

Symptoms: Asthma has gotten worse byfar since contracting covid in February. Still wake nightlygasoing for air at least twice a night and have to use my emergency inhaler. Lots of lingering mucus and cough frequently to attempt to express it.

Free-text releases are not linked to a specific 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	Asthma	·	·	✓
SD	Bone pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Influenza	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sleep disorder	·	·	✓
SD	Sneezing	·	·	✓
SRO	Ocular discomfort	✓	✓	✓

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