Y5G-33037-07577

4 vaccinations 15 coded responses 49 check-ins 15 free-text entries 9 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 808 / CO
Registered: 2020-12-17

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

2020-12-17
Registered in v-safe
2020-12-17
Dose 1 — Pfizer-BioNTech
2020-12-17
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2020-12-18
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2020-12-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache · Be unable to work

Adult check-in
2020-12-20
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2020-12-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Diarrhea

Adult check-in
2020-12-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2020-12-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Headache, Rhinorrhoea — Feeling: Fair

Free text: Headaches, diarrhea, runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Dose 2 — Pfizer-BioNTech
2021-01-07
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-14
Report sent to call center — day 7, dose 2
Be unable to work

1 call case(s)
2021-01-21
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Poor · 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

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Report sent to call center — day 14, 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)
2021-01-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-11
Survey response — day 35, dose 2
MedDRA: Cough, Dyspepsia — Feeling: Good

Free text: Cough, heartburn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 42, dose 2
MedDRA: Fatigue, Headache, Pyrexia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Fever, headache, fatigue on 2/16-2/18

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — 3 months, dose 2
MedDRA: Headache, Sinusitis — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visit

Free text: Sinus infection, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — 3 months, 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)
2021-05-10
Call successful
Participant prefers to complete VAERS report online
2021-05-10
Call successful
Participant prefers to complete VAERS report online
2021-07-08
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-07
Survey response — 12 months, dose 2
MedDRA: Cerebral thrombosis, Pre-existing disease — Feeling: Fair

Free text: Post covid symptoms, daughter had blood clot in brain

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Dose 3 — Pfizer-BioNTech
2022-01-21
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2022-01-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-01-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache

Adult check-in
2022-01-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-27
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-02-03
Survey response — day 14, dose 3
MedDRA: Dizziness, Headache — Feeling: Fair

Free text: Dizzy, headache

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Survey response — day 21, dose 3
MedDRA: Cough, Diarrhoea, Headache, Nausea, Oropharyngeal pain, Respiratory tract congestion, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat, cough, congestion, headache, n/v/d

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Report sent to call center — day 21, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-11
Call successful
Does not wish to fill out VAERS report
2022-02-18
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-24
Survey response — day 35, dose 3
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Still struggling with cold from the last 3 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-03-03
Survey response — day 42, dose 3
MedDRA: Cough, Insomnia, Lower respiratory tract infection, Myalgia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Still with a bad chest cold. Round two of antibiotics. Can't sleep. Horrible cough. Tongue muscle hurts.

MedDRA releases: 2024-11 · check-in free text available
2022-03-03
Report sent to call center — day 42, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-04
Call 1 — Left Voicemail
2022-04-21
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-07-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-23
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-09-24
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-28
Survey response — days 1–6 daily, dose 4
MedDRA: Cough, Oropharyngeal pain — Feeling: Poor · Fever · Headache, Diarrhea · 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: Sore throat, cough

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Report sent to call center — days 1–6 daily, dose 4
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)
2022-09-29
Survey response — days 1–6 daily, dose 4
MedDRA: COVID-19, Office visit — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, 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, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Covid positive this morning at urgent care · Healthcare visit (other): Urgent care, covid positive

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-29
Call 2 — Left Voicemail
2022-09-29
Call 1 — Left Voicemail
2022-09-30
Health check-in — day 7, dose 4
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-07
Call 3 — Left Voicemail
2022-10-07
Call 2 — Left Voicemail
2022-10-07
Call 1 — Left Voicemail
2022-10-09
Survey response — day 14, dose 4
MedDRA: Dizziness, Eructation, Feeling abnormal, Tremor — Feeling: Poor · Be unable to do your normal daily activities

Free text: Generally feeling poor. Shakey, dizzy, belchy

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-21
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-04
Survey response — day 42, dose 4
MedDRA: Headache, Pyrexia, Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever, vertigo, headache

MedDRA releases: 2024-11 · check-in free text available
2022-12-23
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Got covid twice in 10 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-12-23
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-24
Health check-in — 6 months, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-17	Pfizer-BioNTech
2	2021-01-07	Pfizer-BioNTech
3	2022-01-20	Pfizer-BioNTech	No
4	2022-09-23	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2020-12-20	priority 2/3
2021-01-14	priority 2/3
2021-01-21	Successful 2021-05-10	Participant prefers to complete VAERS report online
2021-04-08	Successful 2021-05-10	Participant prefers to complete VAERS report online
2022-02-10	Successful 2022-02-11	Does not wish to fill out VAERS report
2022-03-03	Unsuccessful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-28	Successful 2022-12-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-29	Successful 2022-12-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-23	Successful 2022-12-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — day 14, dose 1

2020-12-31

Symptoms: Headaches, diarrhea, runny nose

Release 2 — day 14, dose 2

2021-01-21

Symptoms: Headaches

Release 4 — day 35, dose 2

2021-02-11

Symptoms: Cough, heartburn

Release 4 — day 42, dose 2

2021-02-18

Symptoms: Fever, headache, fatigue on 2/16-2/18

Release 7 — 3 months, dose 2

2021-04-08

Symptoms: Sinus infection, headache

Release 10 — 12 months, dose 2

2022-01-07

Symptoms: Post covid symptoms, daughter had blood clot in brain

Release 11 — day 14, dose 3

2022-02-03

Symptoms: Dizzy, headache

Release 11 — day 21, dose 3

2022-02-10

Symptoms: Sore throat, cough, congestion, headache, n/v/d

Release 11 — day 35, dose 3

2022-02-24

Symptoms: Still struggling with cold from the last 3 weeks

Release 11 — day 42, dose 3

2022-03-03

Symptoms: Still with a bad chest cold. Round two of antibiotics. Can't sleep. Horrible cough. Tongue muscle hurts.

Release 12 — days 1–6 daily, dose 4

2022-09-28

Systemic reaction (other): Sore throat, cough

2022-09-29

Systemic reaction (other): Covid positive this morning at urgent care

Healthcare visit (other): Urgent care, covid positive

Release 12 — day 14, dose 4

2022-10-09

Symptoms: Generally feeling poor. Shakey, dizzy, belchy

Release 12 — day 42, dose 4

2022-11-04

Symptoms: Fever, vertigo, headache

Release 12 — 3 months, dose 4

2022-12-23

Symptoms: Got covid twice in 10 weeks

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	COVID-19	·	·	✓
HCVO	Office visit	·	·	✓
SD	Cerebral thrombosis	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyspepsia	✓	✓	✓
SD	Eructation	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Headache	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Myalgia	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Tremor	·	·	✓
SD	Vertigo	·	·	✓
SD	Vomiting	·	·	✓
SRO	Cough	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Office visit	·	·	✓
SRO	Oropharyngeal pain	·	·	✓

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