Z4E-15953-63306

4 vaccinations 5 coded responses 30 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 461 / IN
Registered: 2021-03-06

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

2021-02-12
Dose 1 — Pfizer-BioNTech
2021-03-05
Dose 2 — Pfizer-BioNTech
2021-03-06
Registered in v-safe
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-04-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-05
Survey response — 6 months, dose 2
MedDRA: Sleep apnoea syndrome, Sleep study abnormal — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Had a sleep study, diagnosed with moderate sleep apnea

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-05
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-08
Call 1 — Left Voicemail
2021-09-24
Dose 3 — Pfizer-BioNTech
2021-10-02
Survey response — day 7, dose 3
MedDRA: Fatigue, Immediate post-injection reaction, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Tinnitus — Feeling: Good

Free text: Day of the injection I had buzzing in my ears starting about 15 minutes after the shot and lasting 6-8 hours. Next day, 09/25/2021 I had injection site redness, warmth, mild swelling and tenderness. Experienced mild fatigue for about 3 days, then no.

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-29
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-24
Survey response — 3 months, dose 3
MedDRA: Medical counselling, Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Runny nose & mild congestion 12/16/2021; because we had contact with someone 12/10/21 who after visiting us found out she had been with someone 12/08/21 who tested positive on 12/10/21; my husband and I were tested 12/16/21 rapid test & PCR negative · Healthcare visit (other): Health Department testing center

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-27
Call successful
Participant prefers to complete VAERS report online
2022-01-25
Call 1 — Left Voicemail
2022-03-25
Survey response — 6 months, dose 3
MedDRA: Arthropathy, Joint injury, Office visit, Physiotherapy — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Injured left knee joint · Healthcare visit (other): MD office visit, exam, course of P.T. . Slowly recovered. L knee function now near normal.

MedDRA releases: 2024-11 · check-in free text available
2022-03-25
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

1 call case(s)
2022-03-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-25
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-23
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-06
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-24
Survey response — 6 months, dose 4
MedDRA: COVID-19, Medical counselling — 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: COVID + August 3, 2022 · Healthcare visit (other): Consulted with Primary Care Physician who ordered Paxlovid

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Report sent to call center — 6 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)
2023-04-25
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Pfizer-BioNTech
2	2021-03-05	Pfizer-BioNTech
3	2021-09-24	Pfizer-BioNTech	No
4	2022-04-25	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-05	Successful	Participant prefers to complete VAERS report online
2021-12-24	Successful 2021-12-27	Participant prefers to complete VAERS report online
2022-03-25	Successful 2022-03-28	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-24	Unsuccessful

Free text

Release 9 — 6 months, dose 2

2021-09-05

Symptoms: Had a sleep study, diagnosed with moderate sleep apnea

Release 9 — day 7, dose 3

2021-10-02

Systemic reaction (other): Day of the injection I had buzzing in my ears starting about 15 minutes after the shot and lasting 6-8 hours. Next day, 09/25/2021 I had injection site redness, warmth, mild swelling and tenderness. Experienced mild fatigue for about 3 days, then no. cut off by CDC

Release 10 — 3 months, dose 3

2021-12-24

Symptoms: Runny nose & mild congestion 12/16/2021; because we had contact with someone 12/10/21 who after visiting us found out she had been with someone 12/08/21 who tested positive on 12/10/21; my husband and I were tested 12/16/21 rapid test & PCR negative cut off by CDC

Healthcare visit (other): Health Department testing center

Release 11 — 6 months, dose 3

2022-03-25

Symptoms: Injured left knee joint

Healthcare visit (other): MD office visit, exam, course of P.T. . Slowly recovered. L knee function now near normal.

Release 12 — 6 months, dose 4

2022-10-24

Symptoms: COVID + August 3, 2022

Healthcare visit (other): Consulted with Primary Care Physician who ordered Paxlovid

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	Arthropathy	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
SD	COVID-19	·	·	✓
SD	Joint injury	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sleep apnoea syndrome	✓	·	✓
SD	Sleep study abnormal	✓	·	✓
SRO	Fatigue	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Injection site warmth	·	·	✓
SRO	Tinnitus	·	·	✓

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