Y42-43417-15922

4 vaccinations 4 coded responses 30 check-ins 4 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 112 / NY
Registered: 2021-03-31

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

Timeline

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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Pfizer-BioNTech
2021-03-31
Health check-in — day 0, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Mucous stools — Feeling: Poor · Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · 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, Outpatient clinic or urgent care clinic visit

Free text: Bloody mucus in stool

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Report sent to call center — days 1–6 daily, dose 1
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)
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Haematochezia — Feeling: Fair

Free text: Blood in stool

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-21
Dose 2 — Pfizer-BioNTech
2021-04-21
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
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

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

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

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-15
Call 1 — Left Voicemail
2021-07-23
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Pfizer-BioNTech
2022-04-21
Survey response — 12 months, dose 2
MedDRA: Abdominal pain upper, Aphasia, Asthenia, Brain fog, COVID-19, Decreased appetite, Diarrhoea, Fatigue, Nausea, Oral herpes, Oropharyngeal pain, Rhinorrhoea, Vomiting — Feeling: Good · 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

Free text: Recurring cold sores. COVID-19 (January 2022) with diarrhea, stomach cramping, loss of appetite, nausea, vomiting, fatigue, runny nose, sore throat Still experiencing ongoing fatigue, reduced physical stamina, brain fog, and symptoms of aphasia.

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Report sent to call center — 12 months, 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 · 1 call case(s)
2022-04-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-27
Survey response — 6 months, dose 3
MedDRA: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative, Tonsillar hypertrophy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat, swollen tonsils, runny nose. Tested negative for COVID and strep, and don't think this is related to booster (which I received months ago).

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-28
Call 1 — Left Voicemail
2022-10-16
Dose 4 — Moderna
2022-10-25
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2022-11-06
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-15
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Pfizer-BioNTech
2	2021-04-21	Pfizer-BioNTech
3	2021-10-25	Pfizer-BioNTech	No
4	2022-10-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-03	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-21	Successful 2022-04-22	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-27	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-03

Systemic reaction (other): Bloody mucus in stool

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Blood in stool

Release 11 — 12 months, dose 2

2022-04-21

Symptoms: Recurring cold sores. COVID-19 (January 2022) with diarrhea, stomach cramping, loss of appetite, nausea, vomiting, fatigue, runny nose, sore throat Still experiencing ongoing fatigue, reduced physical stamina, brain fog, and symptoms of aphasia.

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Sore throat, swollen tonsils, runny nose. Tested negative for COVID and strep, and don't think this is related to booster (which I received months ago).

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
SD	Abdominal pain upper	·	·	✓
SD	Aphasia	·	·	✓
SD	Asthenia	·	·	✓
SD	Brain fog	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Nausea	·	·	✓
SD	Oral herpes	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Tonsillar hypertrophy	·	·	✓
SD	Vomiting	·	·	✓
SRO	Haematochezia	✓	✓	✓
SRO	Mucous stools	✓	✓	✓

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