XWB-62194-87336

3 vaccinations 5 coded responses 36 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 553 / MN
Registered: 2021-04-22

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

Registered dependents

E9N-32845-94561 Child or adolescent in my care · Male · 2021-08-10

Timeline

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

2021-04-20
Dose 1 — Pfizer-BioNTech
2021-04-22
Registered in v-safe
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-05-04
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-05-11
Dose 2 — Pfizer-BioNTech
2021-05-11
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-18
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-05-25
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-06-01
Survey response — 21 day, dose 2
MedDRA: Fatigue — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-08
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-06-15
Survey response — 35 day, dose 2
MedDRA: Headache, Neck pain, Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-15
Report sent to call center — 35 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-08-11
Survey response — 3 month, dose 2
MedDRA: Dyspnoea, Fatigue, Liver disorder, Medical counselling — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-11
Report sent to call center — 3 month, dose 2
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)
2021-08-18
Call 1 — Left Voicemail
2021-11-09
Survey response — 6 month, dose 2
MedDRA: Diarrhoea, Myalgia, Office visit — Feeling: Poor · 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

MedDRA releases: 2024-11 · check-in answers available
2021-11-09
Report sent to call center — 6 month, dose 2
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)
2021-11-10
Call 1 — Could Not Reach Participant
2021-11-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-24
Dose 3 — Pfizer-BioNTech
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-01
Health check-in — 7 day, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-08
Survey response — 14 day, dose 3
MedDRA: Headache, Hypertension — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11 · check-in answers available
2021-12-08
Report sent to call center — 14 day, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-12-09
Call 1 — Could Not Reach Participant
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2021-12-15
Health check-in — 21 day, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2022-01-05
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-02-23
Health check-in — 3 month, dose 3
Feeling: Fair

Adult check-in
2022-05-25
Health check-in — 6 month, dose 3
Feeling: Poor

Adult check-in
2022-11-26
Health check-in — 12 month, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-20	Pfizer-BioNTech
2	2021-05-11	Pfizer-BioNTech
3	2021-11-24	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-15	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-11	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-09	Successful 2021-11-15	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-08	Successful 2021-12-14	Participant prefers to complete VAERS report online

Free text

Release 8

Symptoms: Fatigue

Release 9

Symptoms: Headaches have recently been worse even with working with pt and head pain and neck clinic. Not sure if it because of shot or not

Healthcare visit (other): Chiropractor and pt because already being seen by them

Symptoms: Liver issues, breathing issues, fatique issues. Seen at least once per week for last 4 weeks. Dr says not shot related but wirth noting

Release 10

Symptoms: Muscle aches, unexplained diarrhea

Healthcare visit (other): Ra specialist and gi specialist

Symptoms: Headaches, high blood pressure

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	Office visit	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Liver disorder	✓	·	✓
SD	Medical counselling	✓	·	✓
SD	Myalgia	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓

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