Z4A-19004-01558

3 vaccinations 4 coded responses 32 check-ins 4 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 980 / WA
Registered: 2021-04-13

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-13
Registered in v-safe
2021-04-13
Dose 1 — Pfizer-BioNTech
2021-04-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Self-medication — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · 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: Taking medication for pain, a steroid and prescription ibuprofen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-20
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Taking medication

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-04
Dose 2 — Pfizer-BioNTech
2021-05-04
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, 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
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-11
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 21, dose 2
MedDRA: Bronchitis — Feeling: Fair · 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: Ended up with bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — day 21, 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)
2021-06-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-08
Dose 3 — Pfizer-BioNTech
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-17
Health check-in — day 7, dose 3
Feeling: Fair · Site: Swelling, Itching · None

Adult check-in
2021-12-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Call 1 — Left Voicemail
2022-06-13
Survey response — 6 months, dose 3
MedDRA: Pregnancy — Feeling: Good · 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: I am now pregnant

MedDRA releases: 2024-11 · check-in free text available
2022-06-13
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-14
Call 1 — Left Voicemail
2022-06-14
Call 1 — Left Voicemail
2022-06-14
Call 1 — Left Voicemail
2022-06-14
Call 2 — Left Voicemail
2022-06-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Pfizer-BioNTech
2	2021-05-04	Pfizer-BioNTech
3	2021-12-08	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-17	Unsuccessful
2021-04-19	Unsuccessful
2021-04-20	Unsuccessful
2021-05-27	Unsuccessful
2022-06-13	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-19

Healthcare visit (other): Taking medication for pain, a steroid and prescription ibuprofen

Release 7 — day 7, dose 1

2021-04-20

Healthcare visit (other): Taking medication

Release 8 — day 21, dose 2

2021-05-27

Symptoms: Ended up with bronchitis

Release 12 — 6 months, dose 3

2022-06-13

Symptoms: I am now pregnant

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	Self-medication	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Bronchitis	✓	✓	✓
SD	Pregnancy	·	·	✓

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