Y24-19780-54056

3 vaccinations 7 coded responses 30 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 427 / KY
Registered: 2021-02-19

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

Registered dependents

DPH-10554-61886 Other · Male · 2022-01-08

Timeline

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

2021-02-19
Registered in v-safe
2021-02-19
Dose 1 — Pfizer-BioNTech
2021-02-19
Survey response — day 0, dose 1
MedDRA: Immediate post-injection reaction, Injection site pain — Feeling: Good

Free text: A Slight brief stinging a couple of times at entry point of shot about 10 minutes after the shot. Normal tenderness in arm around shot area about 4 hours after shot. Normal vaccine reaction for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Injection site reaction, Musculoskeletal stiffness — Feeling: Good

Free text: Just quite a bit of soreness and stiffness in the muscle of the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Injection site reaction, Musculoskeletal stiffness — Feeling: Good

Free text: None of the above and the initial i jection site stiffness and soreness is 90% gone and only lasted about 20 to 24 hours! I need to add the shot did not hurt at all.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-02-26
Survey response — day 7, dose 1
MedDRA: Appendicitis, Hospitalisation — Feeling: Good · Vomiting, Abdominal pain · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Had to go to the hospital for appendicitis. · Healthcare visit (other): I had appendicitis an therefore a lapendectomy. Not sure if the vaccine had any influence in this.???Released today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Pfizer-BioNTech
2021-03-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Pain in extremity, Pyrexia, Somnolence — Feeling: Good · Site: Pain · Chills

Free text: Other than sore arm and slight chills from only 1 degree of fever, I have just felt mild tiredness I believe from some sleepiness last night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Chills

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 21, dose 2
MedDRA: Medical counselling, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Upper respiratory infection contracted through my grandson who had just started in class school that week anx became ill first. · Healthcare visit (other): Went to Little clinic and gad a covid rapid test which was negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-08
Call 1 — Left Voicemail
2021-06-08
Call 1 — Left Voicemail
2021-06-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Call 2 — Left Voicemail
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Dose 3 — Pfizer-BioNTech
2021-12-12
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-12
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-12
Survey response — 6 months, dose 3
MedDRA: Influenza like illness, Lower respiratory tract infection, Office visit, Oropharyngeal pain, Upper respiratory tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I had an upper and lower respiratory infection with a brief mild sore throat flu like symptoms which I contracted through my grandson who brought it home from school and daughter . It lasted 5 weeks. · Healthcare visit (other): Kroger's Little clinic

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-11
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Pfizer-BioNTech
2	2021-03-12	Pfizer-BioNTech
3	2021-11-11	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-26	Successful 2022-05-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-04-02	Successful 2022-05-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-12	Successful 2022-05-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — day 0, dose 1

2021-02-19

Systemic reaction (other): A Slight brief stinging a couple of times at entry point of shot about 10 minutes after the shot. Normal tenderness in arm around shot area about 4 hours after shot. Normal vaccine reaction for me.

Release 4 — days 1–6 daily, dose 1

2021-02-20

Systemic reaction (other): Just quite a bit of soreness and stiffness in the muscle of the injection site.

2021-02-21

Systemic reaction (other): None of the above and the initial i jection site stiffness and soreness is 90% gone and only lasted about 20 to 24 hours! I need to add the shot did not hurt at all.

Release 4 — day 7, dose 1

2021-02-26

Systemic reaction (other): Had to go to the hospital for appendicitis.

Healthcare visit (other): I had appendicitis an therefore a lapendectomy. Not sure if the vaccine had any influence in this.???Released today.

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Other than sore arm and slight chills from only 1 degree of fever, I have just felt mild tiredness I believe from some sleepiness last night.

Release 6 — day 21, dose 2

2021-04-02

Symptoms: Upper respiratory infection contracted through my grandson who had just started in class school that week anx became ill first.

Healthcare visit (other): Went to Little clinic and gad a covid rapid test which was negative.

Release 11 — 6 months, dose 3

2022-05-12

Symptoms: I had an upper and lower respiratory infection with a brief mild sore throat flu like symptoms which I contracted through my grandson who brought it home from school and daughter . It lasted 5 weeks.

Healthcare visit (other): Kroger's Little clinic

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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	Hospitalisation	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	SARS-CoV-2 test negative	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Upper respiratory tract infection	✓	✓	✓
SRO	Appendicitis	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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