Z2A-16991-05557

4 vaccinations 6 coded responses 20 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 606 / IL
Registered: 2021-10-14

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

Registered dependents

QMD-31725-72554 Child or adolescent in my care · Female · 2021-11-14

Timeline

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

2021-04-04
Dose 1 — Pfizer-BioNTech
2021-04-22
Dose 2 — Pfizer-BioNTech
2021-10-13
Dose 3 — Pfizer-BioNTech
Co-administered: Pneumonia
2021-10-14
Registered in v-safe
2021-10-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-10-15
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site swelling, Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work or attend school

Free text: Arm swelling in the injection area as well as the glands in my arm pit

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-10-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-20
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-27
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-03
Survey response — day 21, dose 3
MedDRA: Cough — Feeling: Good

Free text: I've had a mild cough for a few days.

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-12
Survey response — 3 months, dose 3
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Survey response — 6 months, dose 3
MedDRA: COVID-19, Condition aggravated, Office visit, Pre-existing disease — Feeling: Good · 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: Symptoms: Potential flair up / worsening of autoimmune conditions that already exists prior to my having covid in late December - January (formally diagnosed as covid on 1/8/22). · Healthcare visit (other): Normal Dr. Apt.

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-14
Call 1 — Requested Callback
2022-04-19
Call 2 — Left Voicemail
2022-09-29
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-13
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-03
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-10
Survey response — day 42, dose 4
MedDRA: Asthma, Pre-existing disease, Respiratory disorder — 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

Free text: My asthma has gotten MUCH worse since my last vaccine and every cold has hit me way harder in my respiratory system

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Report sent to call center — day 42, 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)
2022-11-11
Call 3 — Left Voicemail
2022-11-11
Call 1 — Left Voicemail
2022-12-29
Survey response — 3 months, dose 4
MedDRA: Cough, Food aversion, Nausea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I cannot drink coffee anymore without nausea and I have a dry cough that will not go away.

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-30
Call X — Left Voicemail
2022-12-30
Call 2 — Left Voicemail
2022-12-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-04	Pfizer-BioNTech	No
2	2021-04-22	Pfizer-BioNTech	No
3	2021-10-13	Pfizer-BioNTech	Pneumonia
4	2022-09-29	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-04-13	Unsuccessful
2022-11-10	Unsuccessful
2022-12-29	Unsuccessful

Free text

Release 10 — days 1–6 daily, dose 3

2021-10-15

Systemic reaction (other): Arm swelling in the injection area as well as the glands in my arm pit

Release 10 — day 21, dose 3

2021-11-03

Symptoms: I've had a mild cough for a few days.

Release 10 — 3 months, dose 3

2022-01-12

Symptoms: Covid.

Release 11 — 6 months, dose 3

2022-04-13

Symptoms: Potential flair up / worsening of autoimmune conditions that already exists prior to my having covid in late December - January (formally diagnosed as covid on 1/8/22).

Healthcare visit (other): Normal Dr. Apt.

Release 12 — day 42, dose 4

2022-11-10

Symptoms: My asthma has gotten MUCH worse since my last vaccine and every cold has hit me way harder in my respiratory system

Release 12 — 3 months, dose 4

2022-12-29

Symptoms: I cannot drink coffee anymore without nausea and I have a dry cough that will not go away.

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	Office visit	·	·	✓
SD	Asthma	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Food aversion	·	·	✓
SD	Nausea	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory disorder	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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