XWP-20754-92190

5 vaccinations 5 coded responses 53 check-ins 4 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 217 / MD
Registered: 2021-04-02

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Registered dependents

YUK-15627-60030 Child or adolescent in my care · Male · 2022-09-17

Timeline

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

2021-03-31
Dose 1 — Pfizer-BioNTech
2021-04-02
Registered in v-safe
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — 7 day, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-21
Dose 2 — Pfizer-BioNTech
2021-04-21
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Neuropathy peripheral — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — 7 day, dose 2
Feeling: Good · None

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

Adult check-in
2021-05-12
Survey response — 21 day, dose 2
MedDRA: Ear pain, Hypoaesthesia, Migraine, Paraesthesia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-12
Report sent to call center — 21 day, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-19
Survey response — 28 day, dose 2
MedDRA: Headache, Migraine, Nausea, Neuropathy peripheral, Office visit, Vertigo — Feeling: Fair · Be unable to work, 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
2021-05-19
Report sent to call center — 28 day, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-07-21
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-20
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Pfizer-BioNTech
2021-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Nausea

Adult check-in
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — 7 day, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — 14 day, dose 3
Feeling: Fair

Adult check-in
2021-11-14
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-12-03
Survey response — 42 day, dose 3
MedDRA: Migraine, Nausea, Physiotherapy — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-12-03
Report sent to call center — 42 day, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-06
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-21
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Moderna
2022-04-09
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2022-04-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-04-17
Health check-in — 7 day, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-22
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 21 day, dose 4
Feeling: Fair

Adult check-in
2022-05-06
Health check-in — 28 day, dose 4
Feeling: Fair

Adult check-in
2022-05-13
Health check-in — 35 day, dose 4
Feeling: Fair

Adult check-in
2022-05-20
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2022-07-08
Health check-in — 3 month, dose 4
Feeling: Fair

Adult check-in
2022-09-10
Dose 5 — Other-Unknown
2022-09-17
Health check-in — 7 day, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — 14 day, dose 5
Feeling: Good

Adult check-in
2022-10-01
Health check-in — 21 day, dose 5
Feeling: Good

Adult check-in
2022-10-16
Health check-in — 35 day, dose 5
Feeling: Good

Adult check-in
2022-10-23
Health check-in — 42 day, dose 5
Feeling: Good

Adult check-in
2022-12-11
Health check-in — 3 month, dose 5
Feeling: Good

Adult check-in
2023-03-15
Survey response — 6 month, dose 5
MedDRA: Headache, Respiratory tract congestion — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Pfizer-BioNTech
2	2021-04-21	Pfizer-BioNTech
3	2021-10-22	Pfizer-BioNTech	No
4	2022-04-08	Moderna	No
5	2022-09-10	Other-Unknown	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-12	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-19	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-03	Successful 2021-12-06	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 7

Systemic reaction (other): Increased perpheral neuropathy in left UE

Release 8

Symptoms: Recurrent migraines in afternoons; numbness/tingling of extremities akin to neuropathy on L side for hours yesterday, onset during a migraine and after some involuntary calf contraction (not nearly the level of a Charley horse tho); inner ear pain. cut off by CDC

Symptoms: Vertigo, nausea, headaches/migraines, neuropathy

Healthcare visit (other): Physical therapy eval, oncologist check up

Release 10

Symptoms: Migraine nausea

Healthcare visit (other): Physical therapy

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	✓	✓	✓
HCVO	Physiotherapy	·	·	✓
SD	Ear pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neuropathy peripheral	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Vertigo	✓	✓	✓
SRO	Neuropathy peripheral	✓	✓	✓

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