YF9-29340-52166

4 vaccinations 11 coded responses 36 check-ins 10 free-text entries 9 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 220 / VA
Registered: 2021-03-19

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

2021-02-25
Dose 1 — Pfizer-BioNTech
2021-03-18
Dose 2 — Pfizer-BioNTech
2021-03-19
Registered in v-safe
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Asthma — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Asthma, probably from pollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-17
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Allergic reaction to peanut oil

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Call successful
Does not wish to fill out VAERS report
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Office visit, Shoulder arthroplasty — Feeling: Fair · 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: Symptoms: Left shoulder joint replaced not Covid-19 related. · Healthcare visit (other): Outpatient clinic to change my bandage. my

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-17
Call 2 — Could Not Reach Participant
2021-09-23
Call 3 — Left Voicemail
2021-10-06
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-08
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I got the flu shot the same day

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

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

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-12
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling cold, Office visit — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Cold but not chills · Healthcare visit (other): Primary doctor

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Survey response — day 7, dose 3
MedDRA: Contusion, Emergency care, Fall, Office visit — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I got the flu shot the same day. I fell flat down the next morning. · Healthcare visit (other): Ophthalmologist. From ER, bad bruises on face.

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Report sent to call center — day 7, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-14
Call 2 — Left Voicemail
2021-10-20
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-27
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-03
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-11
Survey response — day 35, dose 3
MedDRA: Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have a holter monitor from my Cardiologist. · Healthcare visit (other): Cardiologist

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-12
Call 2 — Left Voicemail
2021-11-18
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-05
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-05
Dose 4 — Pfizer-BioNTech
2022-04-08
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-26
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-03
Survey response — day 28, dose 4
MedDRA: Back pain, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Back pain. Lungs are ok. · Healthcare visit (other): PT

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-04
Call 1 — Left Voicemail
2022-05-10
Survey response — day 35, dose 4
MedDRA: Back pain, Office visit, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Back pain not related to COVID-19 that I don't have. · Healthcare visit (other): Dr office & PT

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call 2 — Left Voicemail
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-17
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-05
Survey response — 3 months, dose 4
MedDRA: Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: UTI

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-06
Call successful
Not applicable - Accidental Reporting
2022-10-04
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-04-07
Survey response — 12 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · 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: 2024-11
2023-04-07
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Pfizer-BioNTech
2	2021-03-18	Pfizer-BioNTech
3	2021-10-06	Pfizer-BioNTech	Flu
4	2022-04-05	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-17	Successful 2021-06-25	Does not wish to fill out VAERS report
2021-09-16	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-12	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-13	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-11	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-03	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-10	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-05	Successful 2022-07-06	Not applicable - Accidental Reporting
2023-04-07	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-22

Systemic reaction (other): Asthma, probably from pollen

Release 9 — 3 months, dose 2

2021-06-17

Symptoms: Allergic reaction to peanut oil

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: Left shoulder joint replaced not Covid-19 related.

Healthcare visit (other): Outpatient clinic to change my bandage. my

Release 10 — days 1–6 daily, dose 3

2021-10-08

Systemic reaction (other): I got the flu shot the same day

2021-10-12

Systemic reaction (other): Cold but not chills

Healthcare visit (other): Primary doctor

Release 10 — day 7, dose 3

2021-10-13

Systemic reaction (other): I got the flu shot the same day. I fell flat down the next morning.

Healthcare visit (other): Ophthalmologist. From ER, bad bruises on face.

Release 10 — day 35, dose 3

2021-11-11

Symptoms: I have a holter monitor from my Cardiologist.

Healthcare visit (other): Cardiologist

Release 11 — day 28, dose 4

2022-05-03

Symptoms: Back pain. Lungs are ok.

Healthcare visit (other): PT

Release 11 — day 35, dose 4

2022-05-10

Symptoms: Back pain not related to COVID-19 that I don't have.

Healthcare visit (other): Dr office & PT

Release 12 — 3 months, dose 4

2022-07-05

Symptoms: UTI

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	Contusion	·	·	✓
HCVO	Emergency care	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
SD	Back pain	·	·	✓
SD	COVID-19	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Office visit	·	·	✓
SD	Shoulder arthroplasty	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Asthma	✓	✓	✓
SRO	Fall	·	·	✓
SRO	Feeling cold	·	·	✓
SRO	Unevaluable event	·	·	✓

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