XXX-81776-41599

4 vaccinations 10 coded responses 32 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 559 / MN
Registered: 2021-03-08

Relationship: Self
Race: N/A
Ethnicity: N/A

Registered dependents

D6M-27725-32272 Child or adolescent in my care · Male · 2022-01-19

7KQ-10076-12124 Child or adolescent in my care · Male · 2022-01-19

TMY-21377-40540 Child or adolescent in my care · Male · 2022-01-19

Timeline

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

2021-02-05
Dose 1 — Pfizer-BioNTech
2021-02-26
Dose 2 — Pfizer-BioNTech
2021-03-08
Registered in v-safe
2021-03-08
Survey response — 7 day, dose 2
MedDRA: Adverse reaction — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-12
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — 21 day, dose 2
MedDRA: Unevaluable event, Vaginal haemorrhage — Feeling: Good · 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
2021-03-19
Report sent to call center — 21 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Survey response — 28 day, dose 2
MedDRA: Iron deficiency anaemia — 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
2021-03-26
Report sent to call center — 28 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Survey response — 35 day, dose 2
MedDRA: Uterine leiomyoma — 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
2021-04-06
Report sent to call center — 35 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-08-29
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in
2021-12-15
Dose 3 — Pfizer-BioNTech
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-12-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-22
Health check-in — 7 day, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-29
Survey response — 14 day, dose 3
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-12-30
Call 1 — Left Voicemail
2022-01-05
Health check-in — 21 day, dose 3
Feeling: Fair

Adult check-in
2022-01-12
Survey response — 28 day, dose 3
MedDRA: Adverse reaction — 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
2022-01-19
Survey response — 35 day, dose 3
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-01-25
Call successful
Does not wish to fill out VAERS report
2022-01-25
Call successful
Does not wish to fill out VAERS report
2022-01-25
Call successful
Does not wish to fill out VAERS report
2022-01-26
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-03-16
Survey response — 3 month, dose 3
MedDRA: Rash — Feeling: Fair · 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
2022-03-16
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-06-16
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-11-15
Dose 4 — Pfizer-BioNTech
2022-11-15
Health check-in — 0 day, dose 4
Feeling: Fair · None

Adult check-in
2022-11-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-11-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches

Adult check-in
2022-11-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches

Adult check-in
2022-11-22
Health check-in — 7 day, dose 4
Feeling: Fair · Muscle or body aches

Adult check-in
2022-11-29
Health check-in — 14 day, dose 4
Feeling: Fair

Adult check-in
2022-12-06
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-12-13
Health check-in — 28 day, dose 4
Feeling: Fair

Adult check-in
2022-12-21
Survey response — 35 day, dose 4
MedDRA: Nasopharyngitis — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-12-27
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2023-05-18
Survey response — 6 month, dose 4
MedDRA: Tinnitus — 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
2023-05-18
Report sent to call center — 6 month, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Pfizer-BioNTech
2	2021-02-26	Pfizer-BioNTech
3	2021-12-15	Pfizer-BioNTech	No
4	2022-11-15	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-19	Successful 2022-01-25	Does not wish to fill out VAERS report
2021-03-26	Successful 2022-01-25	Does not wish to fill out VAERS report
2021-04-06	Successful 2022-01-25	Does not wish to fill out VAERS report
2022-03-16	Successful 2022-03-22	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-05-18	Unsuccessful

Free text

Release 5

Systemic reaction (other): I was not provided with the information for reporting symptoms previous to today. I received my 2nd shot 10 days ago. I had numerous symptoms starting the day after my shot .

Symptoms: Irregular spotting for 7 days

Healthcare visit (other): Will be seeing my Dr. in person for a consultation

Release 6

Symptoms: Diagnosed with iron deficiency anemia

Release 7

Symptoms: Diagnosed with uterine fibroids

Release 10

Symptoms: I'm just so tired

Symptoms: This has just been an on going struggle that started with my initial vaccine series. I don't think the vaccine caused the issues, but I think that the side effects (the finally confirmed proof it messes with women's orriods) brought things to light. cut off by CDC

Symptoms: Congestion and runny nose

Release 11

Symptoms: The truthful answer is yes. I have a unexplained rash, but I don't believe it is necessarily related to the vaccine.

Release 12

Symptoms: Common cold symptoms. There's a lot going around.

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	Adverse reaction	·	·	✓
SD	Fatigue	·	·	✓
SD	Iron deficiency anaemia	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Tinnitus	·	·	✓
SD	Uterine leiomyoma	✓	✓	✓
SD	Vaginal haemorrhage	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓

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