XWN-28890-40784

4 vaccinations 10 coded responses 48 check-ins 9 free-text entries 7 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 786 / TX
Registered: 2021-03-21

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

Registered dependents

VV6-19121-36087 Child or adolescent in my care · Female · 2022-10-07

Timeline

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

2021-03-19
Dose 1 — Pfizer-BioNTech
2021-03-21
Registered in v-safe
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle strain, Pain — Feeling: Fair · Site: Redness, Itching · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-26
Health check-in — 7 day, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-04-09
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-04-16
Dose 2 — Pfizer-BioNTech
2021-04-16
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-04-23
Survey response — 7 day, dose 2
MedDRA: Malaise, Respiratory tract congestion — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-30
Survey response — 14 day, dose 2
MedDRA: Sensation of foreign body — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-07
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — 28 day, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-14
Report sent to call center — 28 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-23
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — 42 day, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-30
Report sent to call center — 42 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-16
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-15
Survey response — 6 month, dose 2
MedDRA: Hypertension — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-10-15
Report sent to call center — 6 month, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-30
Dose 3 — Pfizer-BioNTech
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-11-03
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-11-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-06
Health check-in — 7 day, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-15
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-01-29
Survey response — 3 month, dose 3
MedDRA: Abdominal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-01-29
Report sent to call center — 3 month, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-30
Survey response — 6 month, dose 3
MedDRA: Abdominal pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-04-30
Report sent to call center — 6 month, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-10-06
Dose 4 — Pfizer-BioNTech
2022-10-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Nausea, Abdominal pain

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-13
Health check-in — 7 day, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-20
Health check-in — 14 day, dose 4
Feeling: Fair

Adult check-in
2022-10-27
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-11-03
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-11-10
Survey response — 35 day, dose 4
MedDRA: Malaise, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-11-17
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2023-01-07
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2023-04-08
Survey response — 6 month, dose 4
MedDRA: Large intestine polyp, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2023-04-08
Report sent to call center — 6 month, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Pfizer-BioNTech
2	2021-04-16	Pfizer-BioNTech
3	2021-10-30	Pfizer-BioNTech	No
4	2022-10-06	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-14	Successful 2021-10-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-05-30	Successful 2021-10-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-15	Successful 2021-10-18	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-03	Successful 2021-11-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-29	Successful 2022-02-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-30	Successful 2022-05-03	Participant prefers to complete VAERS report online
2023-04-08	Unsuccessful

Free text

Release 6

Systemic reaction (other): It feels like I pulled a neck muscle (which I may have). Its been very painful today

Release 7

Systemic reaction (other): Im very congested and feel sick

Release 8

Symptoms: I have a feeling of something stuck in my throat, its been about two weeks now

Symptoms: I was diagnosed with GERD this week. Its probably been going on for a month or two

Symptoms: I have mild GERD

Release 10

Symptoms: High blood pressure- it likely has been high since the spring but I recently found out about it

Release 11

Symptoms: Abdominal pain that comes and goes

Symptoms: Since my booster in November I've had abdominal pain on my left side. My doctor can't figure out what is causing it but we have run some tests. It seems to be getting better over the past two months

Release 12

Symptoms: I've been sick with a cold and a sore throat, congestion etc

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	Abdominal pain	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Large intestine polyp	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sensation of foreign body	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Muscle strain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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